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General NPI Number Information
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NPI Number | 1356418974
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Entity Type | Organization
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Legal Business Name | THROCKMORTON COUNTY MEMORIAL HOSP
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 12/11/2017
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Provider Practice Location Address
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Address Line | 802 N MINTER AVE
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City | THROCKMORTON
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State | TX
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Zip | 76483-5375
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Country | US
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Telephone | 940-849-2151
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Fax | 940-849-7141
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Provider Business Mailing Address
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Address Line | 802 N MINTER AVE PO BOX 729
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City | THROCKMORTON
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State | TX
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Zip | 76483-5375
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Country | US
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Telephone | 940-849-2151
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Fax | 940-849-7141
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Authorized Official
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Title or Position | CEO
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Name | MR. KIRBY GOBER
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Credential | DVM
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Telephone | 940-849-2151
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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 | 000428
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License Number State | TX
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