Provider Demographics
NPI:1952728990
Name:ANDREWS COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:ANDREWS COUNTY HOSPITAL DISTRICT
Other - Org Name:PRMC HOSPICE
Other - Org Type:Doing Business As
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:PO BOX 2108
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:TX
Mailing Address - Zip Code:79714-2108
Mailing Address - Country:US
Mailing Address - Phone:432-525-3637
Mailing Address - Fax:432-523-6023
Practice Address - Street 1:1801 NE MUSTANG DR
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:TX
Practice Address - Zip Code:79714-3632
Practice Address - Country:US
Practice Address - Phone:432-525-3637
Practice Address - Fax:432-523-6023
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANDREWS COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-27
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX003115251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
741545Medicare PIN