Provider Demographics
NPI:1821277211
Name:HARDEMAN COUNTY MEMORIAL HOSP
Entity Type:Organization
Organization Name:HARDEMAN COUNTY MEMORIAL HOSP
Other - Org Name:FOARD COUNTY MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BETTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-663-2795
Mailing Address - Street 1:PO BOX 90
Mailing Address - Street 2:
Mailing Address - City:QUANAH
Mailing Address - State:TX
Mailing Address - Zip Code:79252-0090
Mailing Address - Country:US
Mailing Address - Phone:940-663-2795
Mailing Address - Fax:940-663-5149
Practice Address - Street 1:200 NORTH FIRST STREET
Practice Address - Street 2:
Practice Address - City:CROWELL
Practice Address - State:TX
Practice Address - Zip Code:79227
Practice Address - Country:US
Practice Address - Phone:940-684-1515
Practice Address - Fax:940-684-1953
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARDEMAN COUNTY MEMORIAL HOSP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-01
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX458848Medicare UPIN