Provider Demographics
NPI:1811916901
Name:TERRY MEMORIAL HOSPITAL DISTRICT
Entity type:Organization
Organization Name:TERRY MEMORIAL HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-637-3551
Mailing Address - Street 1:705 E FELT ST
Mailing Address - Street 2:
Mailing Address - City:BROWNFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:79316-3439
Mailing Address - Country:US
Mailing Address - Phone:806-637-3551
Mailing Address - Fax:806-637-8102
Practice Address - Street 1:705 E FELT ST
Practice Address - Street 2:
Practice Address - City:BROWNFIELD
Practice Address - State:TX
Practice Address - Zip Code:79316-3439
Practice Address - Country:US
Practice Address - Phone:806-637-3551
Practice Address - Fax:806-637-8102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000078251E00000X, 261QA1903X, 3416L0300X, 282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
No251E00000XAgenciesHome Health
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130618504Medicaid
TX102621100OtherFIRSTCARE
TX130618503Medicaid
TX130618505Medicaid
TX137414100OtherFIRSTCARE AMB
NMA3060Medicaid
TX130618502Medicaid
TX130618508Medicaid
TXHH0016OtherBCBS HOSP
NMA3060Medicaid
TXHH0016OtherBCBS HOSP