Provider Demographics
NPI:1215983598
Name:REFUGIO COUNTY MEMORIAL HOSPITAL DISTRICT
Entity type:Organization
Organization Name:REFUGIO COUNTY MEMORIAL HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:
Authorized Official - Last Name:WASICEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-526-2321
Mailing Address - Street 1:107 1/2 SWIFT ST
Mailing Address - Street 2:
Mailing Address - City:REFUGIO
Mailing Address - State:TX
Mailing Address - Zip Code:78377-2425
Mailing Address - Country:US
Mailing Address - Phone:361-526-5328
Mailing Address - Fax:
Practice Address - Street 1:107 1/2 SWIFT ST
Practice Address - Street 2:
Practice Address - City:REFUGIO
Practice Address - State:TX
Practice Address - Zip Code:78377-2425
Practice Address - Country:US
Practice Address - Phone:361-526-5328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REFUGIO CO. MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-26
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QC0050XAmbulatory Health Care FacilitiesClinic/CenterCritical Access Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0633489-01Medicaid
TX0179368-01Medicaid
TX0633489-01Medicaid