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NPI Code Detail

MEDICARE: FANNIN COUNTY HOSPITAL AUTHORITY

MEDICARE: FANNIN COUNTY HOSPITAL AUTHORITY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194166132
Entity Type Code : Organization
Provider Name (Legal Business Name) : FANNIN COUNTY HOSPITAL AUTHORITY
Provider Business Mailing Address
First Line : 504 LIPSCOMB ST
Second Line :
City : BONHAM
State : TX
Zip : 75418-4028
Country : US
Telephone Number : 817-283-4771
Fax Number : 817-283-4020
Provider Business Practice Location Address
First Line : 1960 BEDFORD RD
Second Line :
City : BEDFORD
State : TX
Zip : 76021-5722
Country : US
Telephone Number : 817-283-4771
Fax Number : 817-283-4020
Authorized Official
Title or Position : PRESIDENT
Name : CLARK SANDERSON
Credential :
Telephone Number : 817-372-7224
Provider Enumeration Date : 07/06/2013
Last Update Date : 04/10/2026

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Directions to “FANNIN COUNTY HOSPITAL AUTHORITY ” Practice Location

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