Shackelford County Hospital District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

209004 Issued in TX

Legal business name

SHACKELFORD COUNTY HOSPITAL DISTRICT

Doing business as

Shackelford County EMS

Practice address

432 Kenshalo
Albany, TX 76430

Phone

(325) 762-3313

Fax

(325) 762-2342

NPI assigned

Oct 19, 2006

Last updated

Dec 2, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeff S Davis

Title

Board Member

Phone

(325) 762-3313

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Shackelford County EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Tax ID family

Shackelford County Hospital District3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Shackelford County Hospital District

  dba Sanders Drug Store

  • Community/Retail Pharmacy
  • Albany, TX
  • NPI 1376919977
  NPD tax ID
• Shackelford County Hospital District

  • Land Ambulance
  • Albany, TX
  • NPI 1841272366
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Shackelford County Health Clinic

  • Family Medicine Physician
  • Albany, TX
  • NPI 1184942799

  Member Of

  NPD member

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322784000000",
    "number": "1952483307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 KENSHALO",
            "city": "ALBANY",
            "state": "TX",
            "postal_code": "76430",
            "telephone_number": "325-762-3313",
            "fax_number": "325-762-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 KENSHALO",
            "city": "ALBANY",
            "state": "TX",
            "postal_code": "76430",
            "telephone_number": "325-762-3313",
            "fax_number": "325-762-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHACKELFORD COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2011-12-02",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "325-762-3313"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "209004",
            "primary": false
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TX",
            "license": "209004",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "209004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158946701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shackelford County EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shackelford County Community Resource Center (ResourceCare Baird)
• Shackelford County Community Resource Center (ResourceCare Albany)
• Shackelford County Health Clinic
• Shackelford County Hospital District (Sanders Drug Store)
• Shackelford County Hospital District
• Shackelford County Rural Health (Rural Care Clinic)
• Howard Luther Todd, R. PH.
• Claire Ware, FNP-C
• Travis Ray Wilburn, FNP-C

• Land Ambulance in Albany, TX
• Providers in Albany, TX by specialty
• Land Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.