Healthcare Provider Details

I. General information

NPI: 1649032038
Provider Name (Legal Business Name): CHILDRESS COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 02/09/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 NORTH 18TH STREET
MEMPHIS TX
79245-2009
US

IV. Provider business mailing address

4150 INTERNATIONAL PLAZA SUITE 200
FORT WORTH TX
76109-4875
US

V. Phone/Fax

Practice location:
  • Phone: 806-259-3566
  • Fax: 682-257-8969
Mailing address:
  • Phone: 817-348-8959
  • Fax: 817-348-0466

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: MS. HOLLY HOLCOMB
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 940-937-6371