Provider Demographics
NPI:1629478466
Name:DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT
Other - Org Name:COON MEMORIAL PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEROY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-244-9267
Mailing Address - Street 1:PO BOX 2014
Mailing Address - Street 2:
Mailing Address - City:DALHART
Mailing Address - State:TX
Mailing Address - Zip Code:79022-6014
Mailing Address - Country:US
Mailing Address - Phone:806-244-9267
Mailing Address - Fax:
Practice Address - Street 1:1411 DENVER AVE
Practice Address - Street 2:
Practice Address - City:DALHART
Practice Address - State:TX
Practice Address - Zip Code:79022-4809
Practice Address - Country:US
Practice Address - Phone:806-244-4571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX133463336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy