Provider Demographics
NPI:1245366103
Name:STRATFORD HOSPITAL DISTRICT
Entity type:Organization
Organization Name:STRATFORD HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:LANNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-396-2844
Mailing Address - Street 1:PO BOX 106
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:TX
Mailing Address - Zip Code:79084-0106
Mailing Address - Country:US
Mailing Address - Phone:806-396-2844
Mailing Address - Fax:806-396-2086
Practice Address - Street 1:1109 BEAVER ROAD
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:TX
Practice Address - Zip Code:79084
Practice Address - Country:US
Practice Address - Phone:806-396-2844
Practice Address - Fax:806-396-2086
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STRATFORD HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-26
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211001302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization