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General NPI Number Information
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NPI Number | 1205239266
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Entity Type | Organization
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Legal Business Name | JACK COUNTY HOSPITAL DISTRICT
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Dates
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Enumeration Date | 10/06/2014
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 501 N MAIN ST
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City | COLLINSVILLE
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State | TX
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Zip | 76233-5106
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Country | US
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Telephone | 903-429-6426
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Fax | 903-429-6240
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Provider Business Mailing Address
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Address Line | 215 CHISHOLM TRL
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City | JACKSBORO
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State | TX
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Zip | 76458-1403
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Country | US
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Telephone | 940-567-6633
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Fax |
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Authorized Official
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Title or Position | FISCAL SERVICES DIRECTOR
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Name | DAWN JONES
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Credential |
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Telephone | 940-216-2262
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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 |
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