Provider Demographics
NPI:1497791867
Name:TARRANT COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:TARRANT COUNTY HOSPITAL DISTRICT
Other - Org Name:TCHD DIAMOND HILL COMMUNITY CLINIC 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:STE LL215
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-7627
Mailing Address - Country:US
Mailing Address - Phone:817-702-7105
Mailing Address - Fax:817-533-7430
Practice Address - Street 1:3308 DEEN RD
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76106-6524
Practice Address - Country:US
Practice Address - Phone:817-702-7105
Practice Address - Fax:817-533-7430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX159673336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2104151OtherPK
TX251021Medicaid