NPIMap

Organization Active NPI

Ector County Hospital District

Doing business as MCH Pharmacy

  • Community/Retail Pharmacy
  • Odessa, TX
National Provider Identifier
1356076848
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ECTOR COUNTY HOSPITAL DISTRICT
Doing business as
MCH Pharmacy
Practice address
319 Golder Ave
Odessa, TX 79761-5009
Phone
(432) 640-6333
Fax
(432) 640-6322
NPI assigned
Jul 19, 2022
Last updated
Nov 4, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ECTOR COUNTY HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Russell Tippin
Title
Ceo
Phone
(432) 640-2402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

319 Golder Ave
Odessa, TX 79761-5009

Mailing address

500 W 4TH St
Odessa, TX 79761-5001
Phone (432) 640-4300

Other names 1

  • MCH Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220818001232 TX Part B Supplier - Pharmacy 5496657769 Practice locations: Odessa, TX

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Medical Center Hospital ER9 organizations share this tax ID, including this one
Part of
Medical Center Hospital ER

Other organizations with this tax ID 8

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

Locations

319 Golder Ave
Odessa, TX 79761
Phone (432) 640-4300

Ownership & related parties

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Medical Center HospitalOdessa, TX, CCN 450132 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 1975
Encompass Health Rehabilitation Hospital of Midland OdessaMidland, TX, CCN 453057 Hospital 5% Or Greater Indirect Ownership Interest (17%) Jul 1, 2021
Family Health ClinicOdessa, TX, CCN 671912 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2006
Family Health ClinicOdessa, TX, CCN 741933 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2014
MCH Family Health ClinicOdessa, TX, CCN 451162 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2021
MCH Family Health ClinicOdessa, TX, CCN 671081 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2023

Owned or controlled facilities with NPI records 6

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1356076848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615001",
            "telephone_number": "432-640-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 GOLDER AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615009",
            "telephone_number": "432-640-6333",
            "fax_number": "432-640-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECTOR COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ECTOR COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A",
        "authorized_official_last_name": "TIPPIN",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "432-640-2402"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCH Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MCH Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.