Healthcare Provider Details

I. General information

NPI: 1780637132
Provider Name (Legal Business Name): STRATFORD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/05/2015
Certification Date:
Deactivation Date: 05/25/2006
Reactivation Date: 12/11/2006

III. Provider practice location address

1316 S FLORIDA ST
BORGER TX
79007-6306
US

IV. Provider business mailing address

PO BOX 1189
STRATFORD TX
79084-1189
US

V. Phone/Fax

Practice location:
  • Phone: 806-273-3785
  • Fax: 806-274-5976
Mailing address:
  • Phone: 806-396-5598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateTX

VIII. Authorized Official

Name: MARK MOORE
Title or Position: CEO
Credential:
Phone: 806-396-5988