MEDICARE: COMANCHE COUNTY CONSOLIDATED HOSPITAL DISTRICT

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	275N00000X	Medicare Defined Swing Bed Hospital Unit	100123	TX
2	282NR1301X	Rural Acute Care Hospital	000495	TX
3	341600000X	Ambulance	047007	TX
4	282NC0060X	Critical Access Hospital	100123	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1598752404
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMANCHE COUNTY CONSOLIDATED HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	10201 HIGHWAY 16
Second Line	:
City	:	COMANCHE
State	:	TX
Zip	:	76442-4462
Country	:	US
Telephone Number	:	254-879-4900
Fax Number	:	254-879-4990

Provider Business Practice Location Address
First Line	:	10201 HIGHWAY 16
Second Line	:
City	:	COMANCHE
State	:	TX
Zip	:	76442-4462
Country	:	US
Telephone Number	:	254-879-4900
Fax Number	:	254-879-4990

Authorized Official
Title or Position	:	CEO
Name	:	MR. LARRY GENE TROXELL
Credential	:	PHD
Telephone Number	:	254-879-4900

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	09/01/2023

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Directions to “COMANCHE COUNTY CONSOLIDATED HOSPITAL DISTRICT ” Practice Location

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