Healthcare Provider Details

I. General information

NPI: 1285677401
Provider Name (Legal Business Name): JACKSON COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 09/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 SOUTH WELLS STREET
EDNA TX
77957-3745
US

IV. Provider business mailing address

1013 S WELLS ST
EDNA TX
77957-4045
US

V. Phone/Fax

Practice location:
  • Phone: 361-782-7830
  • Fax: 361-781-0812
Mailing address:
  • Phone: 361-782-7830
  • Fax: 361-781-0812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM SATROM
Title or Position: CFO
Credential:
Phone: 361-782-5241