Provider Demographics
NPI:1114991718
Name:LUBBOCK COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:LUBBOCK COUNTY HOSPITAL DISTRICT
Other - Org Name:UMC HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:806-747-5377
Mailing Address - Street 1:1301 50TH ST
Mailing Address - Street 2:SUITE 9
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79412-2939
Mailing Address - Country:US
Mailing Address - Phone:806-747-5377
Mailing Address - Fax:806-747-5465
Practice Address - Street 1:1301 50TH ST
Practice Address - Street 2:SUITE 9
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-2939
Practice Address - Country:US
Practice Address - Phone:806-747-5377
Practice Address - Fax:806-747-5465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX014666251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX095149302Medicaid
TX146846100OtherFIRST CARE TEAM CHOICE
TXHH027HOtherBCBS PROVIDER NUMBER
TX531587OtherBCBS DME PROVIDER NUMBER
TXHH027HOtherBCBS PROVIDER NUMBER