Provider Demographics
NPI:1710974225
Name:HANSFORD COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:HANSFORD COUNTY HOSPITAL DISTRICT
Other - Org Name:FAMILY MEDICAL CLINIC OF HANSFORD COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZGEARLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-659-1111
Mailing Address - Street 1:707 ROLAND ST
Mailing Address - Street 2:
Mailing Address - City:SPEARMAN
Mailing Address - State:TX
Mailing Address - Zip Code:79081-3441
Mailing Address - Country:US
Mailing Address - Phone:806-659-2846
Mailing Address - Fax:806-659-5844
Practice Address - Street 1:705 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:SPEARMAN
Practice Address - State:TX
Practice Address - Zip Code:79081-3407
Practice Address - Country:US
Practice Address - Phone:806-659-2846
Practice Address - Fax:806-659-5833
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANSFORD COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-29
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1116626-03Medicaid
TX1116626-02Medicaid
TX00T70ZOtherBLUE SHIELD
TX1116626-03Medicaid
TX458707Medicare Oscar/Certification