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General NPI Number Information
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NPI Number | 1154324952
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Entity Type | Organization
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Legal Business Name | LIBERTY COUNTY HOSPITAL DISTRICT NO 1
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 1353 NORTH TRAVIS STREET
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City | LIBERTY
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State | TX
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Zip | 77575-3549
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Country | US
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Telephone | 936-336-7316
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Fax | 936-336-7772
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Provider Business Mailing Address
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Address Line | 1353 NORTH TRAVIS STREET
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City | LIBERTY
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State | TX
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Zip | 77575-3549
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Country | US
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Telephone | 936-336-7316
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Fax | 936-336-7772
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Authorized Official
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Title or Position | CEO
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Name | MRS. RHONDA CAMPBELL
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Credential |
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Telephone | 936-336-7316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 000089
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 100072
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License Number State | TX
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