Provider Demographics
NPI:1154497188
Name:FISHER COUNTY DURA-MEDICAL EQUIPMENT CO.
Entity Type:Organization
Organization Name:FISHER COUNTY DURA-MEDICAL EQUIPMENT CO.
Other - Org Name:FISHER COUNTY HOSPITAL DISTRICT
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:RAYE
Authorized Official - Last Name:HELMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-735-2256
Mailing Address - Street 1:774 STATE HIGHWAY 70 N
Mailing Address - Street 2:P.O. DRAWER F
Mailing Address - City:ROTAN
Mailing Address - State:TX
Mailing Address - Zip Code:79546-6918
Mailing Address - Country:US
Mailing Address - Phone:325-735-2256
Mailing Address - Fax:325-735-3070
Practice Address - Street 1:774 STATE HIGHWAY 70 N
Practice Address - Street 2:P.O. DRAWER F
Practice Address - City:ROTAN
Practice Address - State:TX
Practice Address - Zip Code:79546-6918
Practice Address - Country:US
Practice Address - Phone:325-735-2256
Practice Address - Fax:325-735-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0072523332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX530947OtherBLUE CROSS BLUE SHIELD
TX530947OtherBLUE CROSS BLUE SHIELD