Provider Demographics
NPI:1891837431
Name:JORDAN HEALTH SERVICES PAS-HEMPHILL
Entity Type:Organization
Organization Name:JORDAN HEALTH SERVICES PAS-HEMPHILL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-489-0131
Mailing Address - Street 1:PO BOX 638
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-0008
Mailing Address - Country:US
Mailing Address - Phone:409-489-0131
Mailing Address - Fax:409-489-9201
Practice Address - Street 1:714 W GIBSON ST
Practice Address - Street 2:SUITE 4
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-4958
Practice Address - Country:US
Practice Address - Phone:409-489-0131
Practice Address - Fax:409-489-9201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008272251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health