Basic Information
| Provider Information | |||||||||
| NPI: | 1700509577 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PRIME HEALTHCARE SERVICES PAMPA LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 MEDICAL PLAZA | ||||||||
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| City: | PAMPA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8066653721 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 MEDICAL PLAZA | ||||||||
| Address2: | |||||||||
| City: | PAMPA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8066653721 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2022 | ||||||||
| LastUpdateDate: | 09/26/2022 | ||||||||
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| AuthorizedOfficialLastName: | DOAN | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGING ASSOCIATE GENERAL COUNSEL | ||||||||
| AuthorizedOfficialTelephone: | 3102594706 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | Y | Hospitals | General Acute Care Hospital | Critical Access |
No ID Information.