Provider Demographics
NPI:1558492546
Name:LYNN COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:LYNN COUNTY HOSPITAL DISTRICT
Other - Org Name:LCHD - FAMILY WELLNESS CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:IT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:D
Authorized Official - Last Name:GOSSETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-998-4533
Mailing Address - Street 1:1701 LOCKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:TAHOKA
Mailing Address - State:TX
Mailing Address - Zip Code:79373
Mailing Address - Country:US
Mailing Address - Phone:806-998-4604
Mailing Address - Fax:806-561-4047
Practice Address - Street 1:1701 LOCKWOOD ST
Practice Address - Street 2:
Practice Address - City:TAHOKA
Practice Address - State:TX
Practice Address - Zip Code:79373
Practice Address - Country:US
Practice Address - Phone:806-998-4604
Practice Address - Fax:806-561-4047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000192282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122466104OtherFIRSTCARE
TX092893905OtherSUPERIORHEALTHPLAN
TX132814803Medicaid
TX092893905OtherFIRSTCARESTAR
TX8N9345OtherBLUECROSSBLUESHIELD
TX092893905OtherSUPERIORHEALTHPLAN