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EAST TEXAS MEDICAL CENTER JACKSONVILLE NPI 1285689133


NPI Information

NPI: 1285689133
Provider Name: EAST TEXAS MEDICAL CENTER JACKSONVILLE
Classification: General Acute Care Hospital - 282N00000X
Entity Type: Organization
Address:
501 S RAGSDALE ST
JACKSONVILLE, TX
ZIP 75766
Phone: (903) 541-5000
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EAST TEXAS MEDICAL CENTER JACKSONVILLE is a general acute care hospital in Jacksonville, TX. The provider is an acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. EAST TEXAS MEDICAL CENTER JACKSONVILLE NPI is 1285689133. The provider is registered as an organization entity type.

The provider's business location address is:

501 S RAGSDALE ST
JACKSONVILLE, TX
ZIP 75766-467
Phone: (903) 541-5000
Fax: (903) 541-5067

The provider's authorized official is Jack R Endres .
The authorized official title is Administrator and has the following contact phone number (903) 541-5000.

The enumeration date for this NPI number is 5/22/2006 and was last updated on 12/2/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1282N00000XGeneral Acute Care Hospital000416TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1201848301MEDICAIDTEXAS
2130612806MEDICAIDTEXAS
31023342755OTHERTEXASDBA ETMC FIRST PHYSICIANS CLINIC FRANKSTON
4HH0170OTHERTEXASBCBS PROVIDER NUMBER
5130612801MEDICAIDTEXAS
6450194MEDICARE ID-TYPE UNSPECIFIEDTEXASMEDICARE PROVIDER NUMBER
700C38JMEDICARE ID-TYPE UNSPECIFIEDTEXASCRNA - MEDICARE
81972827822OTHERTEXASDBA ETMC FIRST PHYSICIANS CLINIC RUSK
900J11AOTHERTEXASBCBS PROVIDER NUMBER
10130612804MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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