Provider Demographics
NPI:1316070402
Name:LYNN COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:LYNN COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DARMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-998-4533
Mailing Address - Street 1:2600 LOCKWOOD
Mailing Address - Street 2:
Mailing Address - City:TAHOKA
Mailing Address - State:TX
Mailing Address - Zip Code:79373-4118
Mailing Address - Country:US
Mailing Address - Phone:806-998-4533
Mailing Address - Fax:806-561-4049
Practice Address - Street 1:2600 LOCKWOOD
Practice Address - Street 2:
Practice Address - City:TAHOKA
Practice Address - State:TX
Practice Address - Zip Code:79373-4118
Practice Address - Country:US
Practice Address - Phone:806-998-4533
Practice Address - Fax:806-561-4049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX132814804Medicaid
451351Medicare Oscar/Certification