Provider Demographics
NPI:1245649086
Name:ELECTRA HOSPITAL DISTRICT
Entity type:Organization
Organization Name:ELECTRA HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-495-3981
Mailing Address - Street 1:PO BOX 1112
Mailing Address - Street 2:
Mailing Address - City:ELECTRA
Mailing Address - State:TX
Mailing Address - Zip Code:76360-1112
Mailing Address - Country:US
Mailing Address - Phone:940-495-3981
Mailing Address - Fax:
Practice Address - Street 1:115 W PARK AVE
Practice Address - Street 2:
Practice Address - City:IOWA PARK
Practice Address - State:TX
Practice Address - Zip Code:76367-2806
Practice Address - Country:US
Practice Address - Phone:940-592-2731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy