Organization
COMANCHE COUNTY MEDICAL CENTER COMPANY
Active
Organization
COMANCHE COUNTY MEDICAL CENTER COMPANY
Active
Parent organization
COMANCHE COUNTY MEDICAL CENTER COMPANY
Other names
Patrick Street Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMANCHE COUNTY MEDICAL CENTER COMPANY
Authorized official
JASON RAY COGBURN (IT MANAGER)
(254) 879-4900
Entity
Organization
Contact information
Practice address
303 N PATRICK ST, DUBLIN, TX 76446-1918
(254) 445-4709
(254) 335-0990
Mailing address
303 N PATRICK ST, DUBLIN, TX 76446-1918
(254) 445-4709
(254) 335-0990
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150252
—
TX
01
—
7824810002
PTAN
TX
Enumeration date
06/02/2020
Last updated
10/16/2020
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