JACKSON COUNTY HOSPITAL DISTRICT NPI 1992748693

NPI Information

NPI: 1992748693
Provider Name: JACKSON COUNTY HOSPITAL DISTRICT

Doing Business As: JACKSON MEDICAL CLINIC OF EDNA

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
1013A SOUTH WELLS STREET
EDNA, TX
ZIP 77957
Phone: (361) 782-3560
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JACKSON COUNTY HOSPITAL DISTRICT is a rural health clinic center in Edna, TX. JACKSON COUNTY HOSPITAL DISTRICT NPI is 1992748693. The provider is registered as an organization entity type.
The provider Is Doing Business As Jackson Medical Clinic Of Edna.

The provider's business location address is:

1013A SOUTH WELLS STREET
EDNA, TX
ZIP 77957-045
Phone: (361) 782-3560
Fax: (361) 782-5627

The provider's authorized official is Lance Harrison Smiga .
The authorized official title is Administrator/cfo and has the following contact phone number (361) 782-7800.

The CLIA number assigned to this NPI record is 45D0912758 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/13/2006 and was last updated on 5/9/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	063595501	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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