Provider Demographics
NPI:1518783679
Name:FAIRFIELD HOSPITAL DISTRICT
Entity type:Organization
Organization Name:FAIRFIELD HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:AZUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-389-0961
Mailing Address - Street 1:125 NEWMAN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:75840-1419
Mailing Address - Country:US
Mailing Address - Phone:903-389-0961
Mailing Address - Fax:903-389-1601
Practice Address - Street 1:125 NEWMAN ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:TX
Practice Address - Zip Code:75840-1419
Practice Address - Country:US
Practice Address - Phone:903-389-0961
Practice Address - Fax:903-389-1601
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAIRFIELD HOSPITAL DISTRICT DBA FREESTONE MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty