MEDICARE: UNITED REGIONAL HEALTH CARE SYSTEM INC

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center
2	261QR0208X	Mobile Radiology Clinic/Center
3	282N00000X	General Acute Care Hospital	000417	TX

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	00L72S	OTHER	TX	BLUE CROSS HOSP BASED PHY
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	HH0128	OTHER	TX	BLUE CROSS OF TEXAS
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1023013448
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED REGIONAL HEALTH CARE SYSTEM INC

Provider Business Mailing Address
First Line	:	1600 11TH ST
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76301-4388
Country	:	US
Telephone Number	:	940-764-3034
Fax Number	:	940-764-8315

Provider Business Practice Location Address
First Line	:	1600 11TH ST
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76301-4388
Country	:	US
Telephone Number	:	940-764-3034
Fax Number	:	940-764-8315

Authorized Official
Title or Position	:	PRESIDENT & CHIEF EXECUTIVE OFFICER
Name	:	MR. CORY EDMONDSON
Credential	:
Telephone Number	:	940-764-3034

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	03/12/2025

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax: