JACK COUNTY HOSPITAL DISTRICT NPI 1013909936

NPI Information

NPI: 1013909936
Provider Name: JACK COUNTY HOSPITAL DISTRICT

Doing Business As: FAITH COMMUNITY HOSPITAL RURAL HEALTH CLINIC

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

Specialization: Rural Health

Address:
215 CHISHOLM TRL
JACKSBORO, TX
ZIP 76458
Phone: (940) 567-6633
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JACK COUNTY HOSPITAL DISTRICT is a rural health clinic center in Jacksboro, TX. JACK COUNTY HOSPITAL DISTRICT NPI is 1013909936. The provider is registered as an organization entity type.
The provider Is Doing Business As Faith Community Hospital Rural Health Clinic.

The provider's business location address is:

215 CHISHOLM TRL
JACKSBORO, TX
ZIP 76458-403
Phone: (940) 567-6633
Fax: (940) 567-2895

The provider's authorized official is Kim Lee .
The authorized official title is Coo and has the following contact phone number (940) 567-6633.

The enumeration date for this NPI number is 8/17/2005 and was last updated on 7/21/2022.

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	000046	TEXAS	No
2	261QR1300X	Clinic/Center	Rural Health	100322	TEXAS	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
1	092126403	MEDICAID	TEXAS
2	092126401	MEDICAID	TEXAS
3	092126402	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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