Provider Demographics
NPI:1275525214
Name:MULESHOE AREA HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:MULESHOE AREA HOSPITAL DISTRICT
Other - Org Name:MULESHOE AREA MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEENOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-272-4524
Mailing Address - Street 1:708 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MULESHOE
Mailing Address - State:TX
Mailing Address - Zip Code:79347-3627
Mailing Address - Country:US
Mailing Address - Phone:806-272-4524
Mailing Address - Fax:806-272-4938
Practice Address - Street 1:708 S 1ST ST
Practice Address - Street 2:
Practice Address - City:MULESHOE
Practice Address - State:TX
Practice Address - Zip Code:79347-3627
Practice Address - Country:US
Practice Address - Phone:806-272-4524
Practice Address - Fax:806-272-4938
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MULESHOE AREA HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-16
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000631282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130877708Medicaid
TX45Z372Medicare Oscar/Certification
TX451372Medicare Oscar/Certification