Provider Demographics
NPI:1811075138
Name:KIMBLE COUNTY
Entity type:Organization
Organization Name:KIMBLE COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TED
Authorized Official - Middle Name:SPENCER
Authorized Official - Last Name:SANDLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-446-3300
Mailing Address - Street 1:151 HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:JUNCTION
Mailing Address - State:TX
Mailing Address - Zip Code:76849
Mailing Address - Country:US
Mailing Address - Phone:325-446-3300
Mailing Address - Fax:325-446-4665
Practice Address - Street 1:151 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:JUNCTION
Practice Address - State:TX
Practice Address - Zip Code:76849
Practice Address - Country:US
Practice Address - Phone:325-446-3300
Practice Address - Fax:325-446-4665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX137001341600000X
TX134001341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX086400101Medicaid
503523Medicare PIN