MEDICARE: COMANCHE COUNTY MEDICAL CENTER COMPANY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0004X	Compounding Pharmacy
3	3336L0003X	Long Term Care Pharmacy
4	3336S0011X	Specialty Pharmacy
5	3336C0003X	Community/Retail Pharmacy	04397	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2096759	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043313174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMANCHE COUNTY MEDICAL CENTER COMPANY

Provider Business Mailing Address
First Line	:	10201 TEXAS 16
Second Line	:
City	:	COMANCHE
State	:	TX
Zip	:	76442
Country	:	US
Telephone Number	:	325-648-2484
Fax Number	:	325-648-3417

Provider Business Practice Location Address
First Line	:	1503 W FRONT ST
Second Line	:
City	:	GOLDTHWAITE
State	:	TX
Zip	:	76844-2056
Country	:	US
Telephone Number	:	325-648-2484
Fax Number	:	325-648-3417

Authorized Official
Title or Position	:	DIRECTOR OF RETAIL PHARMACY OPS.
Name	:	MISTY HILL
Credential	:
Telephone Number	:	254-879-4900

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	04/16/2025

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Directions to “COMANCHE COUNTY MEDICAL CENTER COMPANY ” Practice Location

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