Provider Demographics
NPI:1730231853
Name:OCHILTREE COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:OCHILTREE COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:STAGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-435-3606
Mailing Address - Street 1:3101 GARRETT DR
Mailing Address - Street 2:
Mailing Address - City:PERRYTON
Mailing Address - State:TX
Mailing Address - Zip Code:79070-5323
Mailing Address - Country:US
Mailing Address - Phone:806-435-3606
Mailing Address - Fax:806-435-2813
Practice Address - Street 1:401 SW 24TH AVE APT 304
Practice Address - Street 2:
Practice Address - City:PERRYTON
Practice Address - State:TX
Practice Address - Zip Code:79070-5126
Practice Address - Country:US
Practice Address - Phone:806-648-7500
Practice Address - Fax:806-435-2813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38351332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX010798901Medicaid
TX1200030001Medicare NSC