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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 Facility117681TX

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 : 1801917497
Entity Type Code : Organization
Provider Name (Legal Business Name) : FANNIN COUNTY HOSPITAL AUTHORITY
Provider Business Mailing Address
First Line : 5300 W SAM HOUSTON PKWY N
Second Line : SUITE 100
City : HOUSTON
State : TX
Zip : 77041-5161
Country : US
Telephone Number : 832-467-6000
Fax Number :
Provider Business Practice Location Address
First Line : 4825 WELLESLEY AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-6148
Country : US
Telephone Number : 817-732-6608
Fax Number :
Authorized Official
Title or Position : SR DIRECTOR AR
Name : KELLE C SANTORO
Credential :
Telephone Number : 832-467-5728
Provider Enumeration Date : 04/02/2007
Last Update Date : 05/04/2017

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Directions to “FANNIN COUNTY HOSPITAL AUTHORITY ” Practice Location

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