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Organization
JACK COUNTY HOSPITAL DISTRICT
Active
Organization
JACK COUNTY HOSPITAL DISTRICT
Active
Other names
faith community hospital amb surg
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIM LEE (COO)
(940) 567-6633
Entity
Organization
Contact information
Practice address
215 CHISHOLM TRL, JACKSBORO, TX 76458-1403
(940) 567-6633
(940) 567-2895
Mailing address
215 CHISHOLM TRL, JACKSBORO, TX 76458-1403
(940) 567-6633
(940) 567-2895
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
119874903
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119874903
—
TX
Enumeration date
10/10/2006
Last updated
07/21/2022
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