Provider Demographics
NPI:1134162472
Name:HANSFORD COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:HANSFORD COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKEISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-659-2226
Mailing Address - Street 1:707 ROLAND ST
Mailing Address - Street 2:
Mailing Address - City:SPEARMAN
Mailing Address - State:TX
Mailing Address - Zip Code:79081-3441
Mailing Address - Country:US
Mailing Address - Phone:806-659-2226
Mailing Address - Fax:806-659-5888
Practice Address - Street 1:710 ROLAND ST
Practice Address - Street 2:
Practice Address - City:SPEARMAN
Practice Address - State:TX
Practice Address - Zip Code:79081-3442
Practice Address - Country:US
Practice Address - Phone:806-659-2226
Practice Address - Fax:806-659-5888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 332B00000X, 3336L0003X
TX299343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143583Medicaid
2097921OtherPK