Provider Demographics
NPI:1972320844
Name:FANNIN COUNTY HOSPITAL AUTHORITY
Entity type:Organization
Organization Name:FANNIN COUNTY HOSPITAL AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:SANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-583-1854
Mailing Address - Street 1:1000 WIGGINS PKWY
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-7465
Mailing Address - Country:US
Mailing Address - Phone:972-686-3000
Mailing Address - Fax:972-698-2671
Practice Address - Street 1:1000 WIGGINS PKWY
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-7465
Practice Address - Country:US
Practice Address - Phone:972-686-3000
Practice Address - Fax:972-698-2671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility