Provider Demographics
NPI:1780767236
Name:DONLEY COUNTY RHC CORPORATION
Entity type:Organization
Organization Name:DONLEY COUNTY RHC CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-874-3531
Mailing Address - Street 1:PO DRAWER K
Mailing Address - Street 2:ONE MEDICAL CENTER DRIVE
Mailing Address - City:CLARENDON
Mailing Address - State:TX
Mailing Address - Zip Code:79226-0300
Mailing Address - Country:US
Mailing Address - Phone:806-874-3531
Mailing Address - Fax:806-874-2244
Practice Address - Street 1:ONE MEDICAL CENTER DRIVE POD K
Practice Address - Street 2:
Practice Address - City:CLARENDON
Practice Address - State:TX
Practice Address - Zip Code:79226-0300
Practice Address - Country:US
Practice Address - Phone:806-874-3531
Practice Address - Fax:806-874-2244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2018-03-15
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-08-01
Provider Licenses
StateLicense IDTaxonomies
TX261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX08377401Medicaid
TX063676301Medicaid
TX122915OtherSUPERIOR
TX08377401Medicaid