Provider Demographics
NPI:1235737008
Name:JACK COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:JACK COUNTY HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:L
Authorized Official - Last Name:BEAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-567-6633
Mailing Address - Street 1:215 CHISHOLM TRL
Mailing Address - Street 2:
Mailing Address - City:JACKSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76458-1403
Mailing Address - Country:US
Mailing Address - Phone:940-567-6633
Mailing Address - Fax:940-567-2895
Practice Address - Street 1:1005 STATE HIGHWAY 16 S
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-3835
Practice Address - Country:US
Practice Address - Phone:940-282-2512
Practice Address - Fax:940-567-2895
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JACK COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health