Provider Demographics
NPI:1821087164
Name:LUBBOCK COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:LUBBOCK COUNTY HOSPITAL DISTRICT
Other - Org Name:UNIVERSITY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER OF EDI SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-761-0843
Mailing Address - Street 1:602 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79415-3364
Mailing Address - Country:US
Mailing Address - Phone:806-775-8200
Mailing Address - Fax:806-472-6802
Practice Address - Street 1:602 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-3364
Practice Address - Country:US
Practice Address - Phone:806-775-8200
Practice Address - Fax:806-472-6802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13799209Medicaid
TX13799204Medicaid
TXHH0741OtherBLUE CROSS
TXHH0741OtherBLUE CROSS
45T686Medicare ID - Type Unspecified
TX13799204Medicaid
TX450686Medicare ID - Type Unspecified
TX13799209Medicaid