Basic Information
| Provider Information | |||||||||
| NPI: | 1154440741 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ARMSTRONG COUNTY MEDICAL CENTER | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | CLAUDE MEDICAL CLINIC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 130 | ||||||||
| Address2: | |||||||||
| City: | CLAUDE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 790190130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8062265611 | ||||||||
| FaxNumber: | 8062266703 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 PARKS STREET | ||||||||
| Address2: | |||||||||
| City: | CLAUDE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8062265611 | ||||||||
| FaxNumber: | 8062266703 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2007 | ||||||||
| LastUpdateDate: | 09/17/2007 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | STEWART | ||||||||
| AuthorizedOfficialFirstName: | SAMUEL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | BOARD ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8062265611 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | TX | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.