Provider Demographics
NPI:1932268661
Name:REEVES COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:REEVES COUNTY HOSPITAL DISTRICT
Other - Org Name:REEVES REGIONAL DIALYSIS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-447-3551
Mailing Address - Street 1:2349 MEDICAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:PECOS
Mailing Address - State:TX
Mailing Address - Zip Code:79772
Mailing Address - Country:US
Mailing Address - Phone:432-447-3551
Mailing Address - Fax:432-447-5434
Practice Address - Street 1:2349 MEDICAL DRIVE
Practice Address - Street 2:
Practice Address - City:PECOS
Practice Address - State:TX
Practice Address - Zip Code:79772
Practice Address - Country:US
Practice Address - Phone:432-447-3551
Practice Address - Fax:432-447-5434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008098261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
452378OtherMEDICARE - DIALYSIS
45Z377OtherMEDICARE SWING-BED
TX170003102Medicaid
451377OtherMEDICARE
TX170003102Medicaid