Provider Demographics
NPI:1780492280
Name:COCHRAN MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:COCHRAN MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KODY
Authorized Official - Middle Name:
Authorized Official - Last Name:KITCHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-266-5566
Mailing Address - Street 1:201 E GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:TX
Mailing Address - Zip Code:79346-3444
Mailing Address - Country:US
Mailing Address - Phone:806-266-5566
Mailing Address - Fax:806-266-5342
Practice Address - Street 1:114 W WILSON AVE
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:TX
Practice Address - Zip Code:79346-2543
Practice Address - Country:US
Practice Address - Phone:806-266-5971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COCHRAN MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-30
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1001114OtherTEXAS EMS LICENSE