Healthcare Provider Details

I. General information

NPI: 1518225077
Provider Name (Legal Business Name): SOUTH WHEELER COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 05/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S MAIN ST
SHAMROCK TX
79079-2820
US

IV. Provider business mailing address

PO BOX 511 1000 S MAIN
SHAMROCK TX
79079-0511
US

V. Phone/Fax

Practice location:
  • Phone: 806-256-2114
  • Fax: 806-256-2423
Mailing address:
  • Phone: 806-256-2114
  • Fax: 806-256-2423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number242006
License Number StateTX

VIII. Authorized Official

Name: MR. DANNY WHITTINGTON
Title or Position: AMBULANCE COORDINATOR
Credential:
Phone: 806-256-5215