Provider Demographics
NPI:1922249101
Name:RANKIN COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:RANKIN COUNTY HOSPITAL DISTRICT
Other - Org Name:RANKIN HOSPITAL MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
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:432-693-2443
Mailing Address - Fax:432-693-2226
Practice Address - Street 1:1611 SPUR 576
Practice Address - Street 2:
Practice Address - City:RANKIN
Practice Address - State:TX
Practice Address - Zip Code:79778-0327
Practice Address - Country:US
Practice Address - Phone:432-693-2443
Practice Address - Fax:432-693-2226
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RANKIN COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-17
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00290261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
451329OtherMEDICARE
451329OtherMEDICARE