Provider Demographics
NPI:1629181565
Name:MCCAMEY CONVALESCENT CENTER
Entity Type:Organization
Organization Name:MCCAMEY CONVALESCENT CENTER
Other - Org Name:MCCAMEY HOSPITAL DISTRICT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LNFA
Authorized Official - Phone:432-652-8626
Mailing Address - Street 1:PO BOX 1200
Mailing Address - Street 2:
Mailing Address - City:MCCAMEY
Mailing Address - State:TX
Mailing Address - Zip Code:79752-1200
Mailing Address - Country:US
Mailing Address - Phone:432-652-8626
Mailing Address - Fax:432-652-4007
Practice Address - Street 1:2500 HWY 305 SOUTH
Practice Address - Street 2:
Practice Address - City:MCCAMEY
Practice Address - State:TX
Practice Address - Zip Code:79752
Practice Address - Country:US
Practice Address - Phone:432-652-8626
Practice Address - Fax:432-652-4007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114925313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114925OtherLICENSE NUMBER
TX005024OtherVENDOR/FACILITY ID