Healthcare Provider Details

I. General information

NPI: 1659353589
Provider Name (Legal Business Name): STRATFORD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 04/28/2020
Certification Date: 04/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4710 SLIDE RD
LUBBOCK TX
79414-3404
US

IV. Provider business mailing address

4710 SLIDE RD
LUBBOCK TX
79414-3404
US

V. Phone/Fax

Practice location:
  • Phone: 806-797-3481
  • Fax: 806-796-1755
Mailing address:
  • Phone: 806-797-3481
  • Fax: 806-796-1755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number139836
License Number StateTX

VIII. Authorized Official

Name: RICHARD CHUMLEY
Title or Position: PRESIDENT
Credential:
Phone: 806-396-5568