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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