MEDICARE: STRATFORD HOSPITAL DISTRICT D/B/A BORGER HEALTHCARE CENTER

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	5044	TX

General Provider Information

NPI Number	:	1407255110
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRATFORD HOSPITAL DISTRICT D/B/A BORGER HEALTHCARE CENTER

Provider Business Mailing Address
First Line	:	PO BOX 1189
Second Line	:
City	:	STRATFORD
State	:	TX
Zip	:	79084-1189
Country	:	US
Telephone Number	:	806-396-5568
Fax Number	:	806-396-5930

Provider Business Practice Location Address
First Line	:	1316 S FLORIDA ST
Second Line	:
City	:	BORGER
State	:	TX
Zip	:	79007-6306
Country	:	US
Telephone Number	:	806-396-5568
Fax Number	:	806-396-5930

Authorized Official
Title or Position	:	PRESIDENT, SHD BOARD OF DIRECTORS
Name	:	RICHARD CHUMLEY
Credential	:
Telephone Number	:	806-396-5568

Provider Enumeration Date	:	08/19/2014
Last Update Date	:	08/19/2014

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