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NPI Code Detail

MEDICARE: COMANCHE COUNTY CONSOLIDATED HOSP. DIST.

MEDICARE: COMANCHE COUNTY CONSOLIDATED HOSP. DIST.
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
1261Q00000XClinic/Center000495TX

General Provider Information

NPI Number : 1154392298
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMANCHE COUNTY CONSOLIDATED HOSP. DIST.
Provider Business Mailing Address
First Line : 10201 HWY 16
Second Line :
City : COMANCHE
State : TX
Zip : 76442-4462
Country : US
Telephone Number : 254-879-4900
Fax Number : 254-879-4992
Provider Business Practice Location Address
First Line : 10201 HWY 16
Second Line :
City : COMANCHE
State : TX
Zip : 76442-4462
Country : US
Telephone Number : 254-879-4900
Fax Number : 254-879-4992
Authorized Official
Title or Position : CEO
Name : MR. KEVIN STOREY
Credential :
Telephone Number : 254-879-4900
Provider Enumeration Date : 01/27/2006
Last Update Date : 02/28/2011

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