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General NPI Number Information
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NPI Number | 1457216665
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Entity Type | Organization
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Legal Business Name | EAST TEXAS COMMUNITY HEALTH SERVICES, INC
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Dates
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Enumeration Date | 12/19/2025
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 1309 S UNIVERSITY DR STE 100
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City | NACOGDOCHES
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State | TX
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Zip | 75961-6486
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Country | US
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Telephone | 936-585-7098
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 632040
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City | NACOGDOCHES
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State | TX
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Zip | 75963-2040
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Country | US
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Telephone | 936-560-5668
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Fax |
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Authorized Official
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Title or Position | BILLING SUPERVISOR
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Name | LINDA SIMPSON FULLER
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Credential |
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Telephone | 936-585-7121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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