Provider Demographics
NPI:1487085478
Name:MIDLAND COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:MIDLAND COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-221-4877
Mailing Address - Street 1:1401 BALLINGER ST
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-5903
Mailing Address - Country:US
Mailing Address - Phone:817-632-1000
Mailing Address - Fax:817-924-6665
Practice Address - Street 1:501 N SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:FORT STOCKTON
Practice Address - State:TX
Practice Address - Zip Code:79735-4602
Practice Address - Country:US
Practice Address - Phone:817-339-6177
Practice Address - Fax:817-339-6178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX67-5722Medicare PIN