Provider Demographics
NPI:1427316116
Name:KNOX COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:KNOX COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO,AO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:B PHARM
Authorized Official - Phone:940-657-3535
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:KNOX CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79529-0608
Mailing Address - Country:US
Mailing Address - Phone:940-657-4036
Mailing Address - Fax:
Practice Address - Street 1:712 SE 5TH ST
Practice Address - Street 2:
Practice Address - City:KNOX CITY
Practice Address - State:TX
Practice Address - Zip Code:79529-2105
Practice Address - Country:US
Practice Address - Phone:940-657-4036
Practice Address - Fax:940-657-4039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX280163336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2134895OtherPK
TX250487Medicaid
TX6712300001Medicare NSC