Provider Demographics
NPI:1407116304
Name:SOUTH PLAINS RURAL HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:SOUTH PLAINS RURAL HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:MADURA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-894-7842
Mailing Address - Street 1:1000 FM 300
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-6235
Mailing Address - Country:US
Mailing Address - Phone:806-894-7842
Mailing Address - Fax:806-894-3378
Practice Address - Street 1:2424 50TH ST
Practice Address - Street 2:SUITE 204
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-2549
Practice Address - Country:US
Practice Address - Phone:806-897-1987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)