Provider Demographics
NPI:1104269448
Name:MIDLAND COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:MIDLAND COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/COO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-221-4877
Mailing Address - Street 1:5001 OFFICE PARK
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-4843
Mailing Address - Country:US
Mailing Address - Phone:432-362-1800
Mailing Address - Fax:
Practice Address - Street 1:5001 OFFICE PARK
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762
Practice Address - Country:US
Practice Address - Phone:432-362-1800
Practice Address - Fax:432-362-5300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1021332Medicaid
TX1021332Medicaid