Provider Demographics
NPI:1639304769
Name:COUNTY OF YOAKUM
Entity Type:Organization
Organization Name:COUNTY OF YOAKUM
Other - Org Name:YOAKUM COUNTY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:COLLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-592-2121
Mailing Address - Street 1:412 MUSTANG AVENUE
Mailing Address - Street 2:
Mailing Address - City:DENVER CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79323-2750
Mailing Address - Country:US
Mailing Address - Phone:806-592-2121
Mailing Address - Fax:806-592-4440
Practice Address - Street 1:412 MUSTANG AVENUE
Practice Address - Street 2:
Practice Address - City:DENVER CITY
Practice Address - State:TX
Practice Address - Zip Code:79323-2750
Practice Address - Country:US
Practice Address - Phone:806-592-2121
Practice Address - Fax:806-592-4440
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF YOAKUM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-19
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No282NC0060XHospitalsGeneral Acute Care HospitalCritical AccessGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00C16VOtherBCBS CRNA