| Organization Name: | PECOS COUNTY MEMORIAL HOSPITAL |
| NPI Number: | 1780873117 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RUSSELL TIPPIN (CEO) |
| Mailing Address: | 387 W I H 10 Fort Stockton |
| State: | TX US |
| Postal Code: | 797352700 |
| Phone Number: | 4323362004 |
| Fax Number: | 4323364545 |
| NPI Enumeration Date: | 10/22/2007 |
| NPI Last Update Date: | 07/28/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |