Provider Demographics
NPI:1508822552
Name:GENERAL HOSPITAL
Entity Type:Organization
Organization Name:GENERAL HOSPITAL
Other - Org Name:IRAAN GENERAL HOSPITAL DISTRICT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:RYBOLT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-639-2575
Mailing Address - Street 1:PO BOX 665
Mailing Address - Street 2:
Mailing Address - City:IRAAN
Mailing Address - State:TX
Mailing Address - Zip Code:79744-0665
Mailing Address - Country:US
Mailing Address - Phone:432-639-2575
Mailing Address - Fax:432-639-6292
Practice Address - Street 1:600 HWY 349 NORTH
Practice Address - Street 2:
Practice Address - City:IRAAN
Practice Address - State:TX
Practice Address - Zip Code:79744-0665
Practice Address - Country:US
Practice Address - Phone:432-639-2575
Practice Address - Fax:432-639-6292
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-26
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000258275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
1508822552OtherMEDICARE DEFINED SWINGBED UNIT
TX45Z307Medicare Oscar/Certification