Provider Demographics
NPI:1083696496
Name:FISHER COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:FISHER COUNTY HOSPITAL DISTRICT
Other - Org Name:ROBY RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-776-2500
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:ROBY
Mailing Address - State:TX
Mailing Address - Zip Code:79543-0066
Mailing Address - Country:US
Mailing Address - Phone:325-776-2500
Mailing Address - Fax:325-776-2355
Practice Address - Street 1:117 NORTH 1ST STREET
Practice Address - Street 2:
Practice Address - City:ROBY
Practice Address - State:TX
Practice Address - Zip Code:79543-0000
Practice Address - Country:US
Practice Address - Phone:325-776-2500
Practice Address - Fax:325-776-2355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-19
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121239101Medicaid
TX121239104Medicaid
TX121239101Medicaid