Provider Demographics
NPI:1396748471
Name:NORTH WHEELER COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:NORTH WHEELER COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIDD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-826-5581
Mailing Address - Street 1:PO BOX 1030
Mailing Address - Street 2:
Mailing Address - City:WHEELER
Mailing Address - State:TX
Mailing Address - Zip Code:79096-1030
Mailing Address - Country:US
Mailing Address - Phone:806-826-5581
Mailing Address - Fax:806-826-3201
Practice Address - Street 1:901 S. SWEETWATER STREET
Practice Address - Street 2:
Practice Address - City:WHEELER
Practice Address - State:TX
Practice Address - Zip Code:79096-1030
Practice Address - Country:US
Practice Address - Phone:806-826-5581
Practice Address - Fax:806-826-3201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2022-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207P00000X
TX000116282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121787905Medicaid
TX1683815Medicaid
TX1683815Medicaid
TX45Z334Medicare Oscar/Certification
TXAMB383Medicare PIN
TX00241TMedicare PIN
TX451334Medicare Oscar/Certification