Provider Demographics
NPI:1194242990
Name:WEATHERFORD HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:WEATHERFORD HEALTH SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIVISION CFO
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-401-8770
Mailing Address - Street 1:713 E ANDERSON ST
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-5705
Mailing Address - Country:US
Mailing Address - Phone:682-582-1000
Mailing Address - Fax:
Practice Address - Street 1:713 E ANDERSON ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-5705
Practice Address - Country:US
Practice Address - Phone:682-582-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEATHERFORD HEALTH SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit