Provider Demographics
NPI:1558313171
Name:CASTRO COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:CASTRO COUNTY HOSPITAL DISTRICT
Other - Org Name:MEDICAL CENTER OF DIMMITT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-647-2194
Mailing Address - Street 1:300 W HALSELL ST
Mailing Address - Street 2:
Mailing Address - City:DIMMITT
Mailing Address - State:TX
Mailing Address - Zip Code:79027-1846
Mailing Address - Country:US
Mailing Address - Phone:806-647-2194
Mailing Address - Fax:806-647-3769
Practice Address - Street 1:300 W HALSELL ST
Practice Address - Street 2:
Practice Address - City:DIMMITT
Practice Address - State:TX
Practice Address - Zip Code:79027-1846
Practice Address - Country:US
Practice Address - Phone:806-647-2194
Practice Address - Fax:806-647-3769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00N49AOtherBLUE CROSS BLUE SHIELD
TX063566601Medicaid
TX063566601Medicaid
TX458679Medicare ID - Type Unspecified