Healthcare Provider Details

I. General information

NPI: 1003845652
Provider Name (Legal Business Name): COMANCHE COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 10/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 65 BOX 8A 202 S FRISCO
COLDWATER KS
67029-9500
US

IV. Provider business mailing address

HC 65 BOX 8A 202 S FRISCO
COLDWATER KS
67029-9500
US

V. Phone/Fax

Practice location:
  • Phone: 620-582-2144
  • Fax: 620-582-2572
Mailing address:
  • Phone: 620-582-2144
  • Fax: 620-582-2572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License NumberH017001
License Number StateKS

VIII. Authorized Official

Name: MRS. LISA A BROOKS
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 620-582-2144