Provider Demographics
NPI:1356076848
Name:ECTOR COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:ECTOR COUNTY HOSPITAL DISTRICT
Other - Org Name:MCH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:TIPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-640-2402
Mailing Address - Street 1:500 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-5001
Mailing Address - Country:US
Mailing Address - Phone:432-640-4300
Mailing Address - Fax:
Practice Address - Street 1:319 GOLDER AVE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-5009
Practice Address - Country:US
Practice Address - Phone:432-640-6333
Practice Address - Fax:432-640-6322
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ECTOR COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-19
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy