Provider Demographics
NPI:1831674209
Name:JACK COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:JACK COUNTY HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-216-2262
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:940-216-2262
Mailing Address - Fax:940-567-2895
Practice Address - Street 1:115 E BYPASS 287
Practice Address - Street 2:
Practice Address - City:ALVORD
Practice Address - State:TX
Practice Address - Zip Code:76225-7778
Practice Address - Country:US
Practice Address - Phone:940-427-2858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health