Provider Demographics
NPI:1518253194
Name:SWISHER MEMORIAL HEALTHCARE SYSTEM
Entity Type:Organization
Organization Name:SWISHER MEMORIAL HEALTHCARE SYSTEM
Other - Org Name:SWISHER MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUCAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-995-3581
Mailing Address - Street 1:PO BOX 808
Mailing Address - Street 2:
Mailing Address - City:TULIA
Mailing Address - State:TX
Mailing Address - Zip Code:79088-0808
Mailing Address - Country:US
Mailing Address - Phone:806-995-3581
Mailing Address - Fax:806-995-8283
Practice Address - Street 1:539 SE 2ND ST
Practice Address - Street 2:
Practice Address - City:TULIA
Practice Address - State:TX
Practice Address - Zip Code:79088-2400
Practice Address - Country:US
Practice Address - Phone:806-995-3581
Practice Address - Fax:806-995-8283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100122282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX316076401Medicaid
TX45-Z349OtherSWING BED
TX451349OtherTULIA CREEK EMS