Provider Demographics
NPI:1467466425
Name:DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT
Other - Org Name:COON MEMORIAL HOSPITAL HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNIEDERJAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-244-9268
Mailing Address - Street 1:210 E TEXAS BLVD
Mailing Address - Street 2:
Mailing Address - City:DALHART
Mailing Address - State:TX
Mailing Address - Zip Code:79022-4322
Mailing Address - Country:US
Mailing Address - Phone:806-244-8738
Mailing Address - Fax:806-244-6604
Practice Address - Street 1:210 E TEXAS BLVD
Practice Address - Street 2:
Practice Address - City:DALHART
Practice Address - State:TX
Practice Address - Zip Code:79022
Practice Address - Country:US
Practice Address - Phone:806-244-8738
Practice Address - Fax:806-244-6604
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-27
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX005693251E00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH074HOtherBCBS OF TEXAS
TX024401401Medicaid
TX001013700Medicaid
TX024401401Medicaid
TX459416Medicare Oscar/Certification