Provider Demographics
NPI:1215924766
Name:HANSFORD COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:HANSFORD COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZGEARLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-659-1111
Mailing Address - Street 1:707 ROLAND ST
Mailing Address - Street 2:
Mailing Address - City:SPEARMAN
Mailing Address - State:TX
Mailing Address - Zip Code:79081-3441
Mailing Address - Country:US
Mailing Address - Phone:806-659-2535
Mailing Address - Fax:806-659-5844
Practice Address - Street 1:707 ROLAND ST
Practice Address - Street 2:
Practice Address - City:SPEARMAN
Practice Address - State:TX
Practice Address - Zip Code:79081-3441
Practice Address - Country:US
Practice Address - Phone:806-659-2535
Practice Address - Fax:806-659-5844
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANSFORD COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-30
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000395207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00D30VOtherBLUE CROSS BLUE SHIELD
TX0820151-03Medicaid
TX00D30VMedicare ID - Type Unspecified