Provider Demographics
NPI:1215495965
Name:ANSON HOSPITAL DISTRICT
Entity type:Organization
Organization Name:ANSON HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-823-1208
Mailing Address - Street 1:11169 SEAN HAGGERTY DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79934-3385
Mailing Address - Country:US
Mailing Address - Phone:915-849-3000
Mailing Address - Fax:915-821-4339
Practice Address - Street 1:11169 SEAN HAGGERTY DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79934-3385
Practice Address - Country:US
Practice Address - Phone:915-849-3000
Practice Address - Fax:915-821-4339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX104756Medicaid