Provider Demographics
NPI:1689899072
Name:MCCAMEY COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:MCCAMEY COUNTY HOSPITAL DISTRICT
Other - Org Name:MCCAMEY HOSPITAL PHYSICIAN GRP PRACTICE
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:GULIHUR
Authorized Official - Suffix:
Authorized Official - Credentials:
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:432-652-4008
Practice Address - Street 1:2500 S HWY 305
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:432-652-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00DT94207P00000X, 207Q00000X, 207R00000X, 207RC0000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122439OtherSUPERIOR-PHYSICIAN
TX082242101Medicaid
TXDB7838OtherPALMETTO-CARDIOLOGY PHYS
TX00DT94OtherBCBS PHYSICIAN
TX104613100OtherFIRST CARE-HOSPITAL PHYS
TXCS4207OtherPALMETTO-HOSPITAL PHYS
TXDB7838OtherPALMETTO-CARDIOLOGY PHYS