MEDICARE: EASTLAND MEMORIAL HOSPITAL DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	108191	TX

General Provider Information

NPI Number	:	1235121245
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTLAND MEMORIAL HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	2722 OLD ANSON RD
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79603-1834
Country	:	US
Telephone Number	:	325-676-1677
Fax Number	:	325-676-3941

Provider Business Practice Location Address
First Line	:	2722 OLD ANSON RD
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79603-1834
Country	:	US
Telephone Number	:	325-676-1677
Fax Number	:	325-676-3941

Authorized Official
Title or Position	:	TREASURER
Name	:	SOON BURNAM
Credential	:
Telephone Number	:	949-540-1249

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	03/01/2021

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Directions to “EASTLAND MEMORIAL HOSPITAL DISTRICT ” Practice Location

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