Provider Demographics
NPI:1043094394
Name:PECOS COUNTY MEMORIAL HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:PECOS COUNTY MEMORIAL HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRISCOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-336-4201
Mailing Address - Street 1:387 W IH 10
Mailing Address - Street 2:
Mailing Address - City:FORT STOCKTON
Mailing Address - State:TX
Mailing Address - Zip Code:79735
Mailing Address - Country:US
Mailing Address - Phone:432-336-7044
Mailing Address - Fax:
Practice Address - Street 1:387 W IH 10
Practice Address - Street 2:
Practice Address - City:FORT STOCKTON
Practice Address - State:TX
Practice Address - Zip Code:79735
Practice Address - Country:US
Practice Address - Phone:432-336-7044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based