Provider Demographics
NPI:1336386978
Name:FISHER COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:FISHER COUNTY HOSPITAL DISTRICT
Other - Org Name:ROBY RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-776-2500
Mailing Address - Street 1:PO BOX L
Mailing Address - Street 2:
Mailing Address - City:ROTAN
Mailing Address - State:TX
Mailing Address - Zip Code:79546-0491
Mailing Address - Country:US
Mailing Address - Phone:325-735-2256
Mailing Address - Fax:325-735-3070
Practice Address - Street 1:774 STATE HIGHWAY 70 NORTH
Practice Address - Street 2:
Practice Address - City:ROTAN
Practice Address - State:TX
Practice Address - Zip Code:79546
Practice Address - Country:US
Practice Address - Phone:325-735-2256
Practice Address - Fax:325-735-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-20
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC5625261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121239101Medicaid