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NPI Code Detail

MEDICARE: LIBERTY COUNTY HOSPITAL DISTRICT NO. 1

MEDICARE: LIBERTY COUNTY HOSPITAL DISTRICT NO. 1
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
1314000000XSkilled Nursing FacilityTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912352766
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIBERTY COUNTY HOSPITAL DISTRICT NO. 1
Provider Business Mailing Address
First Line : 1720 N LOGAN ST
Second Line :
City : TEXAS CITY
State : TX
Zip : 77590-4931
Country : US
Telephone Number : 409-943-4914
Fax Number :
Provider Business Practice Location Address
First Line : 1720 N LOGAN ST
Second Line :
City : TEXAS CITY
State : TX
Zip : 77590-4931
Country : US
Telephone Number : 409-943-4914
Fax Number :
Authorized Official
Title or Position : BOARD PRESIDENT
Name : C. BRUCE STRATTON
Credential :
Telephone Number : 936-336-7400
Provider Enumeration Date : 04/29/2016
Last Update Date : 11/19/2021

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Directions to “LIBERTY COUNTY HOSPITAL DISTRICT NO. 1 ” Practice Location

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