Provider Demographics
NPI:1194720839
Name:WEST COKE COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:WEST COKE COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HOUSTON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:LNFA
Authorized Official - Phone:325-453-2511
Mailing Address - Street 1:PO BOX 1209
Mailing Address - Street 2:
Mailing Address - City:ROBERT LEE
Mailing Address - State:TX
Mailing Address - Zip Code:76945-1209
Mailing Address - Country:US
Mailing Address - Phone:325-453-2511
Mailing Address - Fax:325-453-4338
Practice Address - Street 1:307 W 8TH ST
Practice Address - Street 2:
Practice Address - City:ROBERT LEE
Practice Address - State:TX
Practice Address - Zip Code:76945
Practice Address - Country:US
Practice Address - Phone:325-453-2511
Practice Address - Fax:325-453-4338
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST COKE COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-17
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX133776314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004095001Medicaid
TX004095001Medicaid