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General NPI Number Information
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NPI Number | 1952177040
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Entity Type | Organization
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Legal Business Name | FANNIN COUNTY HOSPITAL AUTHORITY
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Dates
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Enumeration Date | 11/29/2023
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 1511 MONTEZUMA ST
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City | COLUMBUS
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State | TX
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Zip | 78934-2122
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Country | US
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Telephone | 979-733-0500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 218
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City | BONHAM
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State | TX
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Zip | 75418-0218
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BOARD PRESIDENT
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Name | CLARK SANDERSON
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Credential |
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Telephone | 817-372-7224
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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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