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General NPI Number Information
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NPI Number | 1881632875
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Entity Type | Organization
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Legal Business Name | GOODALL-WITCHER HEALTHCARE FOUNDATION
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 03/19/2009
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Provider Practice Location Address
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Address Line | 9295 HIGHWAY 6
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City | MERIDIAN
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State | TX
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Zip | 76665
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Country | US
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Telephone | 254-435-2525
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Fax | 254-435-6025
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Provider Business Mailing Address
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Address Line | PO BOX 528
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City | MERIDIAN
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State | TX
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Zip | 76665-0528
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Country | US
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Telephone | 254-435-2525
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Fax | 254-435-6025
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. CLARENCE FIELDS JR.
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Credential | CHE
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Telephone | 254-675-8322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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