Healthcare Provider Details

I. General information

NPI: 1376019976
Provider Name (Legal Business Name): MCCULLOCH COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 10/05/2025
Certification Date: 10/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 PANTHER WAY
WACO TX
76712-8614
US

IV. Provider business mailing address

9101 PANTHERWAY
WACO TX
76712-8614
US

V. Phone/Fax

Practice location:
  • Phone: 254-666-2164
  • Fax:
Mailing address:
  • Phone: 254-666-2164
  • Fax:

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: TIMOTHY S JONES
Title or Position: CEO
Credential:
Phone: 325-597-2901