Provider Demographics
NPI:1710386768
Name:MULESHOE AREA HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:MULESHOE AREA HOSPITAL DISTRICT
Other - Org Name:MAMC 2ND ST CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-272-4524
Mailing Address - Street 1:708 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MULESHOE
Mailing Address - State:TX
Mailing Address - Zip Code:79347-3627
Mailing Address - Country:US
Mailing Address - Phone:806-272-4524
Mailing Address - Fax:806-272-4938
Practice Address - Street 1:717 W 2ND ST
Practice Address - Street 2:
Practice Address - City:MULESHOE
Practice Address - State:TX
Practice Address - Zip Code:79347-3640
Practice Address - Country:US
Practice Address - Phone:806-272-4524
Practice Address - Fax:806-272-4938
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MULESHOE AREA HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center