Provider Demographics
NPI:1174866735
Name:NIX COMMUNITY GENERAL HOSPITAL, LLC
Entity Type:Organization
Organization Name:NIX COMMUNITY GENERAL HOSPITAL, LLC
Other - Org Name:NIX RURAL HEALTH CLINIC - PEARSALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JON
Authorized Official - Last Name:ELDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-788-1249
Mailing Address - Street 1:414 NAVARRO ST STE 600
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2541
Mailing Address - Country:US
Mailing Address - Phone:210-271-2190
Mailing Address - Fax:
Practice Address - Street 1:105 E HACKBERRY ST STE B
Practice Address - Street 2:
Practice Address - City:PEARSALL
Practice Address - State:TX
Practice Address - Zip Code:78061-4411
Practice Address - Country:US
Practice Address - Phone:830-334-4016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural