NPIMap

Organization Active NPI

Pecos County Memorial Hospital

  • Community Based Hospice Care Agency
  • Fort Stockton, TX
National Provider Identifier
1780873117
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PECOS COUNTY MEMORIAL HOSPITAL
Doing business as
PECOS COUNTY MEMORIAL HOSPITAL HOSPICE
Practice address
387 W Ih 10
Fort Stockton, TX 79735
Phone
(432) 336-7044
Fax
(432) 336-2630
NPI assigned
Oct 22, 2007
Organization subpart
Yes
Parent organization
PECOS COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Authorized official

Name
Ms. Rachelle Rodriguez
Title
Director of Provider Networks
Phone
(432) 336-7044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X TX Primary

Addresses

Primary practice location

387 W Ih 10
Fort Stockton, TX 79735

Mailing address

387 W I H 10
Fort Stockton, TX 79735-2700
Phone (432) 336-2004

Other identifiers 1

IdentifierTypeStateIssuer
001026149MedicaidTX

Other names 1

  • PECOS COUNTY MEMORIAL HOSPITAL HOSPICE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Part of
Pecos County Memorial

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jul 1, 2023 Change of OwnershipThis provider was the seller Pecos County Memorial Hospital HospiceCCN 671732, TX, NPI 1043094394

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573171200000",
    "number": "1780873117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 W I H 10",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "797352700",
            "telephone_number": "432-336-2004",
            "fax_number": "432-336-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 W IH 10",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "79735",
            "telephone_number": "432-336-7044",
            "fax_number": "432-336-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECOS COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PECOS COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2007-10-22",
        "last_updated": "2019-11-08",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "RACHELLE",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER NETWORKS",
        "authorized_official_telephone_number": "432-336-7044",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001026149",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PECOS COUNTY MEMORIAL HOSPITAL HOSPICE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PECOS COUNTY MEMORIAL HOSPITAL HOSPICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Stockton, TX

Sources for this page

Verify at the official NPI Registry.