Provider Demographics
NPI:1245237593
Name:OCHILTREE HOSPITAL DISTRICT
Entity type:Organization
Organization Name:OCHILTREE HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:PAIGE
Authorized Official - Last Name:JUDICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-435-3606
Mailing Address - Street 1:3101 GARRETT DR
Mailing Address - Street 2:
Mailing Address - City:PERRYTON
Mailing Address - State:TX
Mailing Address - Zip Code:79070-5323
Mailing Address - Country:US
Mailing Address - Phone:806-435-3606
Mailing Address - Fax:806-435-2813
Practice Address - Street 1:3101 GARRETT DR
Practice Address - Street 2:
Practice Address - City:PERRYTON
Practice Address - State:TX
Practice Address - Zip Code:79070-5323
Practice Address - Country:US
Practice Address - Phone:806-435-3606
Practice Address - Fax:806-435-2067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-01
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX98282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121902403Medicaid
TXHH0612OtherBLUE CROSS PROVIDER NUMBE
TX001013253Medicaid
TX086324301Medicaid
TX100453100OtherFIRSTCARE ER DOCTOR
TX112704504Medicaid
TX121902404Medicaid
TX010798901Medicaid
TX112704501Medicaid
TX00J44HOtherBLUE CROSS ER DOCTORS
TX105173100OtherFIRSTCARE PROVIDER NUMBER
TX086324301Medicaid
TX00J44HMedicare ID - Type UnspecifiedMEDICARE ER DOCTORS
TX112704504Medicaid
TX001013253Medicaid