| Jacksonville Hospital Llc | |
|
1325 N Dickinson Dr Rusk TX 75785-1051 | |
| (903) 583-3600 | |
| (903) 583-3595 |
| Full Name | Jacksonville Hospital Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1325 N Dickinson Dr, Rusk, Texas |
| Authorized Official Name and Position | Stephen C Petrovich (EVP) |
| Authorized Official Contact | 6152963000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacksonville Hospital Llc 340 Seven Springs Way Ste 100 Brentwood TN 37027-5697 Ph: (615) 296-3000 | Jacksonville Hospital Llc 1325 N Dickinson Dr Rusk TX 75785-1051 Ph: (903) 583-3600 |
| NPI Number | 1770082299 |
|---|---|
| Provider Enumeration Date | 02/10/2018 |
| Last Update Date | 10/01/2023 |
| Medicare PECOS PAC ID | 4284996638 |
|---|---|
| Medicare Enrollment ID | O20180430001199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770082299 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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Etmc First Physicians Clinic Rusk Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1325 N Dickinson Dr, Rusk, TX 75785 Phone: 903-683-3600 Fax: 903-683-3692 |