Provider Demographics
NPI:1740273994
Name:ECTOR COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:ECTOR COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:TIPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-640-2413
Mailing Address - Street 1:PO BOX 7239
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79760-7239
Mailing Address - Country:US
Mailing Address - Phone:432-640-4000
Mailing Address - Fax:432-640-1898
Practice Address - Street 1:500 W 4TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761
Practice Address - Country:US
Practice Address - Phone:432-640-4000
Practice Address - Fax:432-640-1898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135235306Medicaid
TX135235306Medicaid