Provider Demographics
NPI:1336547587
Name:STONEWALL MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:STONEWALL MEMORIAL HOSPITAL
Other - Org Name:SPUR RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-989-3551
Mailing Address - Street 1:821 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:ASPERMONT
Mailing Address - State:TX
Mailing Address - Zip Code:79502-2029
Mailing Address - Country:US
Mailing Address - Phone:940-989-3551
Mailing Address - Fax:940-989-3395
Practice Address - Street 1:907 E HILL ST
Practice Address - Street 2:
Practice Address - City:SPUR
Practice Address - State:TX
Practice Address - Zip Code:79370-2532
Practice Address - Country:US
Practice Address - Phone:806-271-3306
Practice Address - Fax:870-271-4256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-19
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty