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General NPI Number Information
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NPI Number | 1063844306
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Entity Type | Organization
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Legal Business Name | VIBRA HOSPITAL OF AMARILLO LLC
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 07/02/2020
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Provider Practice Location Address
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Address Line | 7501 WALLACE BLVD
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City | AMARILLO
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State | TX
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Zip | 79124-2150
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Country | US
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Telephone | 806-351-1600
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Fax | 806-353-9106
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Provider Business Mailing Address
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Address Line | 5 E RIVER PARK PLACE E #460
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City | FRESNO
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State | CA
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Zip | 93720-1560
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Country | US
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Telephone | 559-892-2500
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Fax | 559-892-2442
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Authorized Official
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Title or Position | SEC/TREAS
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Name | MR. CLINT T. FEGAN
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Credential |
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Telephone | 717-591-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number |
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License Number State | TX
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