Healthcare Provider Details

I. General information

NPI: 1215037940
Provider Name (Legal Business Name): KIMBLE COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2006
Last Update Date: 01/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 MAIN ST
JUNCTION TX
76849-3024
US

IV. Provider business mailing address

2101 MAIN ST
JUNCTION TX
76849-3024
US

V. Phone/Fax

Practice location:
  • Phone: 325-446-3321
  • Fax:
Mailing address:
  • Phone: 325-446-3321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: DONALD FREEMAN
Title or Position: PRESIDENT
Credential:
Phone: 405-878-0202