Provider Demographics
NPI:1922294867
Name:MOTHER FRANCES HOSPITAL WINNSBORO
Entity Type:Organization
Organization Name:MOTHER FRANCES HOSPITAL WINNSBORO
Other - Org Name:MOTHER FRANCES HOSPITAL WINNSBORO RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LEAD PROVIDER ENROMMENT
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:903-510-1113
Mailing Address - Street 1:PO BOX 844665
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4665
Mailing Address - Country:US
Mailing Address - Phone:903-324-6400
Mailing Address - Fax:
Practice Address - Street 1:719 W COKE RD STE 4
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:TX
Practice Address - Zip Code:75494-3060
Practice Address - Country:US
Practice Address - Phone:903-342-3760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOTHER FRANCES HOSPITAL WINNSBORO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-24
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127301307Medicaid
TX138737534Medicaid
TX138737534Medicaid
TX45-8897Medicare PIN