Provider Demographics
NPI:1669822300
Name:RANKIN COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:RANKIN COUNTY HOSPITAL DISTRICT
Other - Org Name:RANKIN COUNTY ER PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-693-1205
Mailing Address - Street 1:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:RANKIN
Mailing Address - State:TX
Mailing Address - Zip Code:79778-0327
Mailing Address - Country:US
Mailing Address - Phone:432-693-1206
Mailing Address - Fax:
Practice Address - Street 1:1611 SPUR 576
Practice Address - Street 2:
Practice Address - City:RANKIN
Practice Address - State:TX
Practice Address - Zip Code:79778
Practice Address - Country:US
Practice Address - Phone:432-693-1206
Practice Address - Fax:432-693-1296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00290207P00000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1679880777Medicare PIN