Provider Demographics
NPI:1780739904
Name:CITY OF PLAINVIEW
Entity type:Organization
Organization Name:CITY OF PLAINVIEW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHURBET
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:806-293-1359
Mailing Address - Street 1:111 E 10TH ST
Mailing Address - Street 2:PLAINVIEW HALE COUNTY HEALTH DEPARTMENT
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-7361
Mailing Address - Country:US
Mailing Address - Phone:806-293-1359
Mailing Address - Fax:806-293-5741
Practice Address - Street 1:111 E 10TH ST
Practice Address - Street 2:ATTN PLAINVIEW HALE COUNTY HEALTH DEPARTMENT
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-7361
Practice Address - Country:US
Practice Address - Phone:806-293-1359
Practice Address - Fax:806-293-5741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX022790201Medicaid
TX022790201Medicaid