Provider Demographics
NPI:1619400785
Name:REAGAN HOSPITAL DISTRICT
Entity type:Organization
Organization Name:REAGAN HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHON
Authorized Official - Middle Name:
Authorized Official - Last Name:VOELKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-884-2561
Mailing Address - Street 1:1300 N MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:BIG LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76932-3202
Mailing Address - Country:US
Mailing Address - Phone:325-884-2561
Mailing Address - Fax:
Practice Address - Street 1:800 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:BIG LAKE
Practice Address - State:TX
Practice Address - Zip Code:76932-3900
Practice Address - Country:US
Practice Address - Phone:325-884-5622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-06
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34943OtherLICENSE NUBMER