Provider Demographics
NPI:1295339315
Name:HASKELL COUNTY HOSPITAL
Entity type:Organization
Organization Name:HASKELL COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SYDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUCEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-228-0612
Mailing Address - Street 1:1400 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:TX
Mailing Address - Zip Code:79521-5426
Mailing Address - Country:US
Mailing Address - Phone:904-228-0612
Mailing Address - Fax:904-864-2779
Practice Address - Street 1:1400 S 1ST ST
Practice Address - Street 2:
Practice Address - City:HASKELL
Practice Address - State:TX
Practice Address - Zip Code:79521-5426
Practice Address - Country:US
Practice Address - Phone:940-228-0612
Practice Address - Fax:940-864-2779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX678562OtherRURAL HEALTH CLINIC