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General NPI Number Information
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NPI Number | 1730428152
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Entity Type | Organization
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Legal Business Name | SAN AUGUSTINE CITY COUNTY HOSPITAL DISTRICT
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Dates
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Enumeration Date | 02/05/2013
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Last Update Date | 02/05/2013
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Provider Practice Location Address
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Address Line | 208 MAPLE ST
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City | SAN AUGUSTINE
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State | TX
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Zip | 75972-2320
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Country | US
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Telephone | 936-288-0027
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 114
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City | SAN AUGUSTINE
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State | TX
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Zip | 75972-0114
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Country | US
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Telephone | 936-288-0027
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | M. JEAN HINES
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Credential |
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Telephone | 936-275-6001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | PROVISIONAL
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License Number State | TX
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