Provider Demographics
NPI:1659054005
Name:COMANCHE COUNTY MEDICAL CENTER COMPANY
Entity Type:Organization
Organization Name:COMANCHE COUNTY MEDICAL CENTER COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINIC OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:
Authorized Official - Last Name:STARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-879-4910
Mailing Address - Street 1:10201 HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:COMANCHE
Mailing Address - State:TX
Mailing Address - Zip Code:76442-4462
Mailing Address - Country:US
Mailing Address - Phone:254-879-4900
Mailing Address - Fax:254-879-4992
Practice Address - Street 1:408 N AUSTIN ST
Practice Address - Street 2:
Practice Address - City:COMANCHE
Practice Address - State:TX
Practice Address - Zip Code:76442-2408
Practice Address - Country:US
Practice Address - Phone:325-356-1135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMANCHE COUNTY MEDICAL CENTER COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health