1790702579 NPI number — COMANCHE COUNTY HOSPITAL AUTHORITY

Table of content: (NPI 1790702579)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790702579 NPI number — COMANCHE COUNTY HOSPITAL AUTHORITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMANCHE COUNTY HOSPITAL AUTHORITY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790702579
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/08/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 785
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWTON
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73502-0785
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-357-9984
Provider Business Mailing Address Fax Number:
580-357-3277

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
823 D ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SNYDER
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73566-2031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-569-2373
Provider Business Practice Location Address Fax Number:
580-569-2611
Provider Enumeration Date:
07/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
BRENT
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
580-355-8620

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  20057 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com