Provider Demographics
NPI:1699705301
Name:FANNIN COUNTY HOSPITAL AUTHORITY
Entity type:Organization
Organization Name:FANNIN COUNTY HOSPITAL AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZERINGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-640-7310
Mailing Address - Street 1:504 LIPSCOMB BLVD.
Mailing Address - Street 2:
Mailing Address - City:BONHAM
Mailing Address - State:TX
Mailing Address - Zip Code:75418-4028
Mailing Address - Country:US
Mailing Address - Phone:903-583-8585
Mailing Address - Fax:903-640-7601
Practice Address - Street 1:504 LIPSCOMB BLVD
Practice Address - Street 2:
Practice Address - City:BONHAM
Practice Address - State:TX
Practice Address - Zip Code:75418-4028
Practice Address - Country:US
Practice Address - Phone:903-583-8585
Practice Address - Fax:903-640-7601
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FANNIN COUNTY HOSPITAL AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-05
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100191275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
45Z370Medicare Oscar/Certification