Provider Demographics
NPI:1790954485
Name:SCURRY COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:SCURRY COUNTY HOSPITAL DISTRICT
Other - Org Name:COGDELL FAMILY CLINIC TEXAS HEALTH STEPS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:EVERETT
Authorized Official - Suffix:
Authorized Official - Credentials:FACHE
Authorized Official - Phone:325-574-7439
Mailing Address - Street 1:1700 COGDELL BLVD
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:TX
Mailing Address - Zip Code:79549-6162
Mailing Address - Country:US
Mailing Address - Phone:325-574-7437
Mailing Address - Fax:325-574-7433
Practice Address - Street 1:1700 COGDELL BLVD
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:TX
Practice Address - Zip Code:79549-6162
Practice Address - Country:US
Practice Address - Phone:325-573-1300
Practice Address - Fax:325-574-6981
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCURRY COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-27
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136330111Medicaid