Provider Demographics
NPI:1033289913
Name:DONLEY COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:DONLEY COUNTY HOSPITAL DISTRICT
Other - Org Name:ASSOCIATED AMBULANCE AUTHORITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-874-2233
Mailing Address - Street 1:PO BOX 1240
Mailing Address - Street 2:
Mailing Address - City:CLARENDON
Mailing Address - State:TX
Mailing Address - Zip Code:79226-1240
Mailing Address - Country:US
Mailing Address - Phone:806-874-2233
Mailing Address - Fax:806-874-2235
Practice Address - Street 1:3 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:CLARENDON
Practice Address - State:TX
Practice Address - Zip Code:79226-6046
Practice Address - Country:US
Practice Address - Phone:806-874-2233
Practice Address - Fax:806-874-2235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX065001341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0863854-01Medicaid
TX503358Medicare PIN