Organization
CONCHO COUNTY HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN LADY (CEO)
(325) 869-5911
Entity
Organization
Contact information
Practice address
614 EAKER ST., EDEN, TX 76837-0987
(325) 869-5911
(325) 869-5218
Mailing address
614 EAKER STREET, EDEN, TX 76837
(325) 869-5911
(325) 869-5218
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0073GN
BLUE CROSS DOCTOR GROUP
TX
05
—
091770005
—
TX
05
—
091770006
—
TX
05
—
091770007
—
TX
01
—
116205
SUPERIOR
TX
01
—
451325
ALL COMMERCIAL INS.
TX
01
—
HH0527
BLUE CROSS HOSPITAL
TX
Enumeration date
12/28/2005
Last updated
03/17/2020
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