Provider Demographics
NPI:1073521944
Name:FALLS COMMUNITY HOSPITAL AND CLINIC
Entity Type:Organization
Organization Name:FALLS COMMUNITY HOSPITAL AND CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-803-3561
Mailing Address - Street 1:322 COLEMAN ST
Mailing Address - Street 2:
Mailing Address - City:MARLIN
Mailing Address - State:TX
Mailing Address - Zip Code:76661-2358
Mailing Address - Country:US
Mailing Address - Phone:254-803-3561
Mailing Address - Fax:254-883-6066
Practice Address - Street 1:322 COLEMAN ST
Practice Address - Street 2:
Practice Address - City:MARLIN
Practice Address - State:TX
Practice Address - Zip Code:76661-2358
Practice Address - Country:US
Practice Address - Phone:254-803-3561
Practice Address - Fax:254-883-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000517275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45U348Medicare PIN