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General NPI Number Information
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NPI Number | 1114388089
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Entity Type | Organization
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Legal Business Name | FANNIN COUNTY HOSPITAL AUTHORITY
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Dates
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Enumeration Date | 03/18/2016
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Last Update Date | 02/26/2021
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Provider Practice Location Address
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Address Line | 2300 JACK FINNEY BLVD
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City | GREENVILLE
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State | TX
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Zip | 75402-3763
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Country | US
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Telephone | 903-455-7942
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Fax | 903-455-0472
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Provider Business Mailing Address
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Address Line | 2300 JACK FINNEY BLVD
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City | GREENVILLE
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State | TX
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Zip | 75402-3763
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Country | US
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Telephone | 903-455-7942
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Fax | 903-455-0472
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Authorized Official
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Title or Position | TREASURER
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Name | SOON BURNAM
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Credential |
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Telephone | 949-540-2149
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | TX
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