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General NPI Number Information
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NPI Number | 1326025701
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Entity Type | Organization
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Legal Business Name | CONCHO COUNTY HOSPITAL
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 03/17/2020
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Provider Practice Location Address
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Address Line | 614 EAKER ST.
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City | EDEN
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State | TX
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Zip | 76837-0987
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Country | US
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Telephone | 325-869-5911
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Fax | 325-869-5218
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Provider Business Mailing Address
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Address Line | 614 EAKER STREET
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City | EDEN
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State | TX
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Zip | 76837
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Country | US
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Telephone | 325-869-5911
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Fax | 325-869-5218
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Authorized Official
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Title or Position | CEO
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Name | MR. BRIAN LADY
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Credential |
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Telephone | 325-869-5911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State |
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