Healthcare Provider Details
I. General information
NPI: 1518032879
Provider Name (Legal Business Name): LOCKNEY GENERAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/22/2006
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
701 COMMERCE STREET
SILVERTON TX
79257
US
IV. Provider business mailing address
P.O. BOX 37
LOCKNEY TX
79241-0037
US
V. Phone/Fax
- Phone: 806-652-3373
- Fax: 806-652-2417
- Phone: 806-652-3373
- Fax: 806-652-2417
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
HEITZENRATER
Title or Position: ADMINISTRATOR
Credential:
Phone: 806-652-3373