Provider Demographics
NPI:1225414501
Name:JPS HOSPITAL
Entity Type:Organization
Organization Name:JPS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:SAJOUS
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:817-702-7400
Mailing Address - Street 1:9424 CRESTING CREEK DR
Mailing Address - Street 2:APT 1122
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76108-7021
Mailing Address - Country:US
Mailing Address - Phone:305-494-6364
Mailing Address - Fax:
Practice Address - Street 1:4701 BRYANT IRVIN RD N
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-7627
Practice Address - Country:US
Practice Address - Phone:817-702-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56835281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital