Provider Demographics
NPI:1275571432
Name:COMANCHE COUNTY HOSPITAL AUTHORITY
Entity Type:Organization
Organization Name:COMANCHE COUNTY HOSPITAL AUTHORITY
Other - Org Name:SILVER LININGS GERIATRIC PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-585-5511
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73502-0129
Mailing Address - Country:US
Mailing Address - Phone:580-250-6650
Mailing Address - Fax:580-250-6655
Practice Address - Street 1:3401 W GORE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6332
Practice Address - Country:US
Practice Address - Phone:580-250-6650
Practice Address - Fax:580-250-6655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100700750AMedicaid
00370056001OtherBLUE CROSS BLUE SHIELD
=========051OtherCHAMPUS