Provider Demographics
NPI:1427086024
Name:NEWBURN HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:NEWBURN HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:ADM
Authorized Official - Phone:903-586-9871
Mailing Address - Street 1:421 S. BONNER ST.
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-2330
Mailing Address - Country:US
Mailing Address - Phone:903-586-9871
Mailing Address - Fax:903-586-5866
Practice Address - Street 1:421 S BONNER ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-2330
Practice Address - Country:US
Practice Address - Phone:903-586-9871
Practice Address - Fax:903-586-5866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116336314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX676092Medicare ID - Type Unspecified