Healthcare Provider Details

I. General information

NPI: 1851725071
Provider Name (Legal Business Name): MITCHELL COUNTY HOSPITAL DISTICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2013
Last Update Date: 08/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 N 15TH ST
LAMESA TX
79331-3025
US

IV. Provider business mailing address

1201 N 15TH ST
LAMESA TX
79331-3025
US

V. Phone/Fax

Practice location:
  • Phone: 806-872-2141
  • Fax: 806-872-2299
Mailing address:
  • Phone: 806-872-2141
  • Fax: 806-872-2299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ROBBIE DEWBERRY
Title or Position: CEO
Credential:
Phone: 325-728-3431