Provider Demographics
NPI:1104026079
Name:SWEETWATER-NOLAN CO HEALTH
Entity Type:Organization
Organization Name:SWEETWATER-NOLAN CO HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:DON
Authorized Official - Last Name:WARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-235-2869
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79556-0457
Mailing Address - Country:US
Mailing Address - Phone:325-235-2869
Mailing Address - Fax:325-236-6856
Practice Address - Street 1:504 E 7TH ST
Practice Address - Street 2:
Practice Address - City:ROTAN
Practice Address - State:TX
Practice Address - Zip Code:79546-2317
Practice Address - Country:US
Practice Address - Phone:325-235-2869
Practice Address - Fax:325-236-6856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2615261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility