EASTLAND MEMORIAL HOSPITAL DISTRICT NPI 1760005953

NPI Information

NPI: 1760005953
Provider Name: EASTLAND MEMORIAL HOSPITAL DISTRICT

Doing Business As: WALNUT STREET CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
WALNUT STREET CLINIC
200 WALNUT STREET CLINIC
RANGER, TX
ZIP 76448
Phone: (254) 647-1182
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EASTLAND MEMORIAL HOSPITAL DISTRICT is a rural health clinic center in Ranger, TX. EASTLAND MEMORIAL HOSPITAL DISTRICT NPI is 1760005953. The provider is registered as an organization entity type.
The provider Is Doing Business As Walnut Street Clinic.

The provider's business location address is:

WALNUT STREET CLINIC
200 WALNUT STREET CLINIC
RANGER, TX
ZIP 76448-644
Phone: (254) 647-1182

The provider's authorized official is Laban Joe Wright .
The authorized official title is Ceo/administrator and has the following contact phone number (254) 631-5342.

The CLIA number assigned to this NPI record is 45D0487940 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/21/2020 and was last updated on 8/26/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	45D0487940	OTHER	TEXAS	CLIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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