Organization Name: | DICKERSON MEMORIAL HOSPITAL, LLC |
NPI Number: | 1003939232 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN TATUM (ADMINISTRATOR) |
Mailing Address: | 1001 Dickerson Dr Jasper |
State: | TX US |
Postal Code: | 759515110 |
Phone Number: | 4093832345 |
Fax Number: | 2814476802 |
NPI Enumeration Date: | 04/10/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 282NR1301X |
License Number: | 007235 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Hospitals |
Taxonomy Classification: | General Acute Care Hospital |
Taxonomy Specialization: | Rural |
Taxonomy Definition: |