Phynet, INC
Clinic/Center, Rural Health in Jefferson, TX. Organization (NPI-2).
NPI number1598093239
StatusActive
Last updated in NPPESMar 19, 2025
Details
- NPI
- 1598093239
- Entity type
- Organization (NPI-2)
- Legal business name
- Phynet, INC
- Organization subpart
- No
- Enumeration date
- Nov 18, 2009
- Certification date
- Mar 19, 2025
- Last updated
- Mar 19, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR1300X | Clinic/Center, Rural Health | – | – | Yes |
Other names
- Jefferson Life Center (Doing Business As)
Practice location
219 N Polk StJefferson, TX 75657-2131
Phone 903-247-0484 · Fax 903-247-0485
Mailing address
4002 Technology CtrLongview, TX 75605-2697
Phone 903-247-0484 · Fax 903-247-0485
Authorized official
John Ford
President
9032470484
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Other Rural Health Clinic/Center providers in Jefferson, TX
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