Provider Demographics
NPI:1932223765
Name:LYNN COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:LYNN COUNTY HOSPITAL DISTRICT
Other - Org Name:LCHD - ER GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DARMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-998-4533
Mailing Address - Street 1:PO BOX 1310
Mailing Address - Street 2:
Mailing Address - City:TAHOKA
Mailing Address - State:TX
Mailing Address - Zip Code:79373-1310
Mailing Address - Country:US
Mailing Address - Phone:806-998-4533
Mailing Address - Fax:806-561-4049
Practice Address - Street 1:2600 LOCKWOOD
Practice Address - Street 2:
Practice Address - City:TAHOKA
Practice Address - State:TX
Practice Address - Zip Code:79373
Practice Address - Country:US
Practice Address - Phone:806-998-4533
Practice Address - Fax:806-561-4049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8053207Q00000X
TXG5016207Q00000X
208D00000X, 261QE0002X, 282N00000X, 363L00000X, 261QE0002X
TX617523363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency CareGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No282N00000XHospitalsGeneral Acute Care HospitalGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX132814809Medicaid
TX132814801Medicaid
TX135110801Medicaid
TX092893905Medicaid
TXQ74960Medicare UPIN
TXTXB119051Medicare PIN
TX8L1901Medicare PIN
TX8G0813Medicare PIN
TX135110801Medicaid
TX8L15472Medicare PIN
TX00D52NMedicare PIN
TX092893905Medicaid
TX132814801Medicaid
TXE52105Medicare UPIN