MEDICARE: JACK COUNTY HOSPITAL DISTRICT

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
1	314000000X	Skilled Nursing Facility

Other Identifiers

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

General Provider Information

NPI Number	:	1376977017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JACK COUNTY HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	405 DUNCAN PERRY RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-5412
Country	:	US
Telephone Number	:	817-649-3366
Fax Number	:	817-633-3513

Provider Business Practice Location Address
First Line	:	405 DUNCAN PERRY RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-5412
Country	:	US
Telephone Number	:	817-649-3366
Fax Number	:	817-633-3513

Authorized Official
Title or Position	:	CEO
Name	:	FRANK L BEAMAN
Credential	:
Telephone Number	:	940-567-6633

Provider Enumeration Date	:	08/29/2013
Last Update Date	:	07/26/2023

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Directions to “JACK COUNTY HOSPITAL DISTRICT ” Practice Location

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