Provider Demographics
NPI:1831691922
Name:CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO. 1
Entity type:Organization
Organization Name:CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO. 1
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-632-1000
Mailing Address - Street 1:1401 BALLINGER ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-5905
Mailing Address - Country:US
Mailing Address - Phone:817-632-1000
Mailing Address - Fax:817-924-6665
Practice Address - Street 1:2407 WEST MAIN HIGHWAY 82
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75426
Practice Address - Country:US
Practice Address - Phone:903-427-3821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-05
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility