Healthcare Provider Details

I. General information

NPI: 1215965991
Provider Name (Legal Business Name): COMANCHE COUNTY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

924 NW 38TH ST
LAWTON OK
73505-3703
US

IV. Provider business mailing address

PO BOX 129
LAWTON OK
73502-0129
US

V. Phone/Fax

Practice location:
  • Phone: 580-355-7655
  • Fax: 580-355-4033
Mailing address:
  • Phone: 580-355-8620
  • Fax: 580-250-6458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number3-S-607
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: BRENT SMITH
Title or Position: CEO
Credential:
Phone: 580-585-5522