Provider Demographics
NPI:1750388005
Name:OCHILTREE HOSPITAL DISTRICT
Entity type:Organization
Organization Name:OCHILTREE HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-435-2122
Mailing Address - Street 1:1501 S TAYLOR ST
Mailing Address - Street 2:C/O TEXAS PANHANDLE FAMILY PLANNING AND HEALTH CENTERS
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79101-4307
Mailing Address - Country:US
Mailing Address - Phone:806-372-8731
Mailing Address - Fax:806-372-8746
Practice Address - Street 1:3019 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PERRYTON
Practice Address - State:TX
Practice Address - Zip Code:79070-5357
Practice Address - Country:US
Practice Address - Phone:806-435-2122
Practice Address - Fax:806-435-3704
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
TX3137251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX023704201Medicaid
TX457640Medicare ID - Type UnspecifiedHOME HEALTH PROVIDER #