Andrews County Hospital District

Organization Active NPI Rural Health Clinic/Center · Andrews, TX

NPI 1124054069 · NPPES record last updated Jul 31, 2026

Key facts

NPI
1124054069
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
ANDREWS COUNTY HOSPITAL DISTRICT
Practice address
700 Hospital Dr
Andrews, TX 79714-3638
Phone
(432) 523-6624
Fax
(432) 523-7901
NPI assigned
Jun 23, 2006
Organization subpart
Yes
Parent organization (as reported)
ANDREWS COUNTY HOSPITAL DISTRICT

Authorized official

Name
Susan Fournier
Title
Cfo
Phone
(432) 464-2107

Owners & managing parties with NPI records 8

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 8

Organizations that report the same tax identification number in the National Provider Directory.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0858613Andrews Family Medicine RHC
700 Hospital Drive, Andrews, TX 79714
Certificate of waiverAug 31, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Rural health clinic certification: CCN 458655

Legal name
ANDREWS COUNTY HOSPITAL DISTRICT
Doing business as
ANDREWS FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 13, 1995
Last certification
Sep 6, 2017
Ownership / control type
For profit – corporation
Organization structure
Government · Non-profit
Enrollment address
700 Hospital Dr
Andrews Family Medicine
Andrews, TX 79714-3638
Related CCNs
450144

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Manual Gonzales
Individual
Corporate Director
Board Member
Jan 31, 2017
Morgan Mason
Individual
Corporate Officer
Chief Financial Officer
Jan 1, 2021
W-2 Managing Employee
Chief Financial Officer
Jan 1, 2020
Carol Boswell
Individual
Corporate Director
Board Member
May 1, 2022
Donny Booth
Individual
W-2 Managing Employee
Ceo
Jul 1, 2012
Melody Starcher
Individual
W-2 Managing Employee Oct 18, 2022
Andrea Warnke
Individual
Corporate Director
Board Member
May 31, 2018
Elizabeth Boynton
Individual
Corporate Director May 26, 2010
Christopher Dallaire
Individual
W-2 Managing Employee
Clinic Director
Jun 29, 2020
Jessica Varner
Individual
Corporate Director
Board Member
May 1, 2022
Andrews County Hospital District
Organization · Andrews, TX
Operational/Managerial Control May 26, 2010
Sarah Bender
Individual
Corporate Director
Board Member
Nov 1, 2023
Mike Sanchez
Individual
Corporate Director
Board Member
Nov 1, 2020

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Permian Regional Medical Center
Andrews, TX · CCN 450144
Hospital Operational/Managerial Control Jan 1, 2003
Permian Regional Medical Center
Andrews, TX · CCN 45U144
Hospital Operational/Managerial Control Jan 1, 2003
Permian Residential Care Center
Andrews, TX · CCN 676175
Skilled nursing facility 5% Or Greater Direct Ownership Interest
Trustee of the SNF
Adp of the SNF
Feb 12, 2003
Feb 12, 2003
Feb 12, 2003
Permian Regional Medical Center Home Health
Andrews, TX · CCN 457596
Home health agency Operational/Managerial Control Nov 1, 2009
Quick Care Clinic
Andrews, TX · CCN 673420
Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 2, 2013

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100521000268 TX Part a Provider - Rural Health Clinic 6002724945 Practice locations: Andrews, TX

National Provider Directory

Tax ID family
Andrews County Hosp Dist (9 organizations share this tax ID)
Part of
Andrews County Hosp Dist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X 000183 TX
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X
Obstetrics & Gynecology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207V00000X
Rural Health Clinic/Center 261QR1300X Yes
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X

Addresses

Primary practice location

700 Hospital Dr
Andrews, TX 79714-3638

Mailing address

700 Hospital Dr
Andrews, TX 79714-3638
Phone (432) 523-6624

Other identifiers

IdentifierTypeStateIssuer
112273103MedicaidTX

Other names

  • ANDREWS FAMILY MEDICINE Doing business as

Other providers in Andrews, TX

All providers in Andrews, TX · Rural Health Clinic/Center in Texas

Sources for this page

Verify at the official NPI Registry.