Provider Demographics
NPI:1518361369
Name:STEPHENS MEMORIAL HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:STEPHENS MEMORIAL HOSPITAL DISTRICT
Other - Org Name:SMH URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:KEMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:254-559-2241
Mailing Address - Street 1:200 S GENEVA ST
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:TX
Mailing Address - Zip Code:76424-4702
Mailing Address - Country:US
Mailing Address - Phone:254-559-2241
Mailing Address - Fax:254-559-7079
Practice Address - Street 1:200 S GENEVA ST
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:TX
Practice Address - Zip Code:76424-4702
Practice Address - Country:US
Practice Address - Phone:254-559-2241
Practice Address - Fax:254-559-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1831196005OtherNPI