Provider Demographics
NPI:1811051964
Name:ANDREWS COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:ANDREWS COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:DYANE
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-464-2107
Mailing Address - Street 1:1601 NE MUSTANG DR
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:TX
Mailing Address - Zip Code:79714-3647
Mailing Address - Country:US
Mailing Address - Phone:432-464-2200
Mailing Address - Fax:432-464-2572
Practice Address - Street 1:1601 NE MUSTANG DR
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:TX
Practice Address - Zip Code:79714-3647
Practice Address - Country:US
Practice Address - Phone:432-464-2430
Practice Address - Fax:432-464-2572
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANDREWS COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-21
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118750313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001004526Medicaid