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General NPI Number Information
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NPI Number | 1679797831
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Entity Type | Organization
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Legal Business Name | JOHNS COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 305 MALLARD LN
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City | TAYLOR
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State | TX
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Zip | 76574-1208
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Country | US
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Telephone | 512-352-4716
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Fax | 512-352-4734
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Provider Business Mailing Address
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Address Line | 305 MALLARD LN
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City | TAYLOR
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State | TX
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Zip | 76574-1208
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Country | US
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Telephone | 512-352-4716
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Fax | 512-352-4734
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Authorized Official
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Title or Position | CEO
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Name | ERNEST BALLA
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Credential | RN, MBA
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Telephone | 512-352-4716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 44
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License Number State | TX
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