MEDICARE: EASTLAND MEMORIAL 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

General Provider Information

NPI Number	:	1891991584
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTLAND MEMORIAL HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	6850 RUFE SNOW DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76148-2355
Country	:	US
Telephone Number	:	817-514-4940
Fax Number	:	817-514-2198

Provider Business Practice Location Address
First Line	:	6850 RUFE SNOW DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76148-2355
Country	:	US
Telephone Number	:	817-514-4940
Fax Number	:	817-514-2198

Authorized Official
Title or Position	:	CEO
Name	:	LABAN JOSEPH WRIGHT
Credential	:
Telephone Number	:	325-754-1317

Provider Enumeration Date	:	06/21/2007
Last Update Date	:	10/29/2024

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Directions to “EASTLAND MEMORIAL HOSPITAL DISTRICT ” Practice Location

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