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NPI 1245664994

NPI 1245664994 : CHILDRESS COUNTY HOSPITAL DISTRICT : BORGER, TX

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General NPI Number Information
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    NPI Number           |    1245664994
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    Entity Type          |    Organization 
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    Legal Business Name  |    CHILDRESS COUNTY HOSPITAL DISTRICT 
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Dates
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    Enumeration Date     |    08/29/2013
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    Last Update Date     |    08/29/2013
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Provider Practice Location Address
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    Address Line         |    1316 S FLORIDA ST 
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    City                 |    BORGER
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    State                |    TX
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    Zip                  |    79007-6306
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    Country              |    US
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    Telephone            |    940-567-6633
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    Fax                  |    940-567-3975
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Provider Business Mailing Address
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    Address Line         |    1316 S FLORIDA ST 
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    City                 |    BORGER
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    State                |    TX
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    Zip                  |    79007-6306
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    Country              |    US
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    Telephone            |    940-567-6633
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    Fax                  |    940-567-3975
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     JOHN M HENDERSON 
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    Credential           |    
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    Telephone            |    940-937-6371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    314000000X
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    Taxonomy Name        |    Skilled Nursing Facility
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    License Number       |    
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    License Number State |    
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