Healthcare Provider Details

I. General information

NPI: 1801221338
Provider Name (Legal Business Name): CHILDRESS COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2013
Last Update Date: 09/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 W KENTUCKY AVE
PAMPA TX
79065-3916
US

IV. Provider business mailing address

1504 W KENTUCKY AVE
PAMPA TX
79065-3916
US

V. Phone/Fax

Practice location:
  • Phone: 806-665-5746
  • Fax: 806-665-6220
Mailing address:
  • Phone: 806-665-5746
  • Fax: 806-665-6220

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: MR. JOHN M HENDERSON
Title or Position: CEO
Credential:
Phone: 940-567-6633