Provider Demographics
NPI:1639714223
Name:STRATFORD HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:STRATFORD HOSPITAL DISTRICT
Other - Org Name:PARK BEND HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-396-5568
Mailing Address - Street 1:2122 PARK BEND DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5352
Mailing Address - Country:US
Mailing Address - Phone:512-836-9777
Mailing Address - Fax:512-833-9759
Practice Address - Street 1:2122 PARK BEND DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5352
Practice Address - Country:US
Practice Address - Phone:512-836-9777
Practice Address - Fax:512-833-9759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-07
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility