Provider Demographics
NPI:1578651162
Name:KNOX COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:KNOX COUNTY HOSPITAL DISTRICT
Other - Org Name:KNOX COUNTY HOSPITAL HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-657-3535
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:KNOX CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79529-0608
Mailing Address - Country:US
Mailing Address - Phone:940-657-3013
Mailing Address - Fax:940-657-5377
Practice Address - Street 1:701 SE 5TH ST
Practice Address - Street 2:
Practice Address - City:KNOX CITY
Practice Address - State:TX
Practice Address - Zip Code:79529
Practice Address - Country:US
Practice Address - Phone:940-657-3013
Practice Address - Fax:940-657-5377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX003586251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX003586OtherPROVIDER LICENSE
TX024037601Medicaid
TXHH8251OtherBC/BS PROVIDER
TX458324Medicare ID - Type Unspecified