Provider Demographics
NPI:1891873204
Name:COMANCHE COUNTY CONSOLIDATED HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:COMANCHE COUNTY CONSOLIDATED HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-356-2509
Mailing Address - Street 1:PO BOX 847
Mailing Address - Street 2:
Mailing Address - City:COMANCHE
Mailing Address - State:TX
Mailing Address - Zip Code:76442-0847
Mailing Address - Country:US
Mailing Address - Phone:325-356-2509
Mailing Address - Fax:325-356-3716
Practice Address - Street 1:108 W OAK AVE
Practice Address - Street 2:
Practice Address - City:COMANCHE
Practice Address - State:TX
Practice Address - Zip Code:76442-3273
Practice Address - Country:US
Practice Address - Phone:325-356-2509
Practice Address - Fax:325-356-3716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8047251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX01004344OtherTDHS VENDOR NUMBER