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General NPI Number Information
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NPI Number | 1649268152
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Entity Type | Organization
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Legal Business Name | COUNTY OF THROCKMORTON
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 10/08/2014
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Provider Practice Location Address
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Address Line | 1504 N 1ST ST
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City | HASKELL
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State | TX
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Zip | 79521-5438
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Country | US
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Telephone | 940-864-8537
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Fax | 940-864-8040
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Provider Business Mailing 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 | 76483-5357
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Country | US
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Telephone | 940-849-2141
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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 | KIRBY GOBER
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Credential |
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Telephone | 940-849-2141
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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 | TX
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