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General NPI Number Information
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NPI Number | 1225320898
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Entity Type | Organization
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Legal Business Name | COMANCHE COUNTY HOSPITAL AUTHORITY
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Dates
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Enumeration Date | 05/13/2011
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Last Update Date | 05/13/2011
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Provider Practice Location Address
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Address Line | 2710 W GORE BLVD
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City | LAWTON
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State | OK
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Zip | 73505-6319
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Country | US
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Telephone | 580-355-7665
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Fax | 580-355-7668
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Provider Business Mailing Address
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Address Line | 924 NW 38TH ST
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City | LAWTON
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State | OK
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Zip | 73505-3703
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Country | US
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Telephone | 580-355-7655
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Fax | 580-355-4033
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Authorized Official
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Title or Position | CFO
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Name | MR. DAVID BLACKMON
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Credential |
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Telephone | 580-355-8699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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