=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750482055
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ELECTRA HOSPITAL DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2006
-----------------------------------------------------
Last Update Date | 03/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 701 S BAILEY ST
-----------------------------------------------------
City | ELECTRA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76360-2839
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-495-4601
-----------------------------------------------------
Fax | 940-495-3611
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1112
-----------------------------------------------------
City | ELECTRA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76360-1112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-495-4601
-----------------------------------------------------
Fax | 940-495-3611
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | REBECCA MCCAIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 940-495-3981
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number | 0037385
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------