| Throckmorton County Memorial Hosp | |
|
802 N Minter Ave Ste B Throckmorton TX 76483-5357 | |
| (940) 849-2151 | |
| (940) 849-7141 |
| Full Name | Throckmorton County Memorial Hosp |
|---|---|
| Speciality | Clinic/Center |
| Location | 802 N Minter Ave Ste B, Throckmorton, Texas |
| Authorized Official Name and Position | Kirby A Gober (CEO) |
| Authorized Official Contact | 9408492151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Throckmorton County Memorial Hosp Po Box 729 Throckmorton TX 76483-0729 Ph: (940) 849-2151 | Throckmorton County Memorial Hosp 802 N Minter Ave Ste B Throckmorton TX 76483-5357 Ph: (940) 849-2151 |
| NPI Number | 1114047875 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 12/08/2017 |
| Medicare PECOS PAC ID | 4082686282 |
|---|---|
| Medicare Enrollment ID | O20040809000910 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114047875 | NPI | - | NPPES |
| 0635682-02 | Medicaid | TX | |
| 0635682-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Craig C Beasley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649330119 PECOS PAC ID: 7911974464 Enrollment ID: I20040914000524 |
| Provider Name | Robert R King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073686929 PECOS PAC ID: 8628100344 Enrollment ID: I20131009000579 |