Provider Demographics
NPI:1407982481
Name:NORTH RUNNELS COUNTY HOSPITAL
Entity Type:Organization
Organization Name:NORTH RUNNELS COUNTY HOSPITAL
Other - Org Name:NORTH RUNNELS HOSPITAL ER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-754-1500
Mailing Address - Street 1:PO BOX 185
Mailing Address - Street 2:
Mailing Address - City:WINTERS
Mailing Address - State:TX
Mailing Address - Zip Code:79567-0185
Mailing Address - Country:US
Mailing Address - Phone:325-754-4553
Mailing Address - Fax:325-754-5097
Practice Address - Street 1:7821 STATE HIGHWAY 153
Practice Address - Street 2:
Practice Address - City:WINTERS
Practice Address - State:TX
Practice Address - Zip Code:79567-7345
Practice Address - Country:US
Practice Address - Phone:325-754-4553
Practice Address - Fax:325-754-5097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000151282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX020989202Medicaid
TX00277TMedicare ID - Type UnspecifiedER PHYSICIANS GROUP