Organization
JACKSONVILLE HOSPITAL LLC
Active
Parent organization
AHS EAST TEXAS HEALTH SYSTEM, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AHS EAST TEXAS HEALTH SYSTEM, LLC
Authorized official
STEPHEN C PETROVICH (EVP)
(615) 296-3000
Entity
Organization
Contact information
Practice address
1325 N DICKINSON DR, RUSK, TX 75785-1051
(903) 583-3600
(903) 583-3595
Mailing address
340 SEVEN SPRINGS WAY STE 100, BRENTWOOD, TN 37027-5697
(615) 296-3000
(615) 296-6227
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/10/2018
Last updated
10/01/2023
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