MEDICARE: FANNIN COUNTY HOSPITAL AUTHORITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1730910886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FANNIN COUNTY HOSPITAL AUTHORITY

Provider Business Mailing Address
First Line	:	215 FM 161 BUSINESS S
Second Line	:
City	:	HUGHES SPRINGS
State	:	TX
Zip	:	75656-6422
Country	:	US
Telephone Number	:	903-639-2561
Fax Number	:	903-639-7348

Provider Business Practice Location Address
First Line	:	215 FM 161 BUSINESS S
Second Line	:
City	:	HUGHES SPRINGS
State	:	TX
Zip	:	75656-6422
Country	:	US
Telephone Number	:	903-639-2561
Fax Number	:	903-639-7348

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	DENVER SHEDDY
Credential	:
Telephone Number	:	903-583-1854

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	08/12/2024

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Directions to “FANNIN COUNTY HOSPITAL AUTHORITY ” Practice Location

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