Provider Demographics
NPI:1205383510
Name:TARRANT COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:TARRANT COUNTY HOSPITAL DISTRICT
Other - Org Name:JPS HEALTH NETWORK CENTRAL FILL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT PHARMACY SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-242-7782
Mailing Address - Street 1:4701 BRYANT IRVIN RD N
Mailing Address - Street 2:LL215
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-7627
Mailing Address - Country:US
Mailing Address - Phone:817-702-3531
Mailing Address - Fax:817-702-6748
Practice Address - Street 1:4701 BRYANT IRVIN RD N
Practice Address - Street 2:LL215
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-7627
Practice Address - Country:US
Practice Address - Phone:817-702-3531
Practice Address - Fax:817-702-6748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-02
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19478333600000X
3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2163943OtherPK