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Comanche County Hospital Authority

Organization Active NPI Federally Qualified Health Center (FQHC) · Lawton, OK

NPI 1346788296 · NPPES record last updated Jan 26, 2018

Key facts

NPI
1346788296
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
COMANCHE COUNTY HOSPITAL AUTHORITY
Practice address
110 NW 31St St
Suite 201
Lawton, OK 73505-6100
Phone
(580) 355-5242
Fax
(580) 355-5245
NPI assigned
Feb 10, 2017
Organization subpart
No

Authorized official

Name
Brent Smith
Title
Ceo
Phone
(580) 355-8620

Corporate family (same tax ID) 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2039019LCHC Primary Health Care Center
110 NW 31St Street, Suite 201, Lawton, OK 73505		Certificate of waiverMar 28, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Federally qualified health center certification: CCN 371933

Legal name
COMANCHE COUNTY HOSPITAL AUTHORITY
Doing business as
LCHC PRIMARY HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 17, 2018
Last certification
May 17, 2018
Ownership / control type
For profit – corporation
Organization structure
Other · Non-profit
Incorporated
Nov 28, 2006 in OK
Enrollment address
110 NW 31St St
Ste 201
Lawton, OK 73505-6100

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
George W Kruger
Individual 		Corporate Director
Cfo		 Aug 3, 2015
W-2 Managing Employee
Cfo		 Aug 3, 2015
Jervis Jackson
Individual 		Corporate Officer
Board Member		 Oct 1, 2022
Amber Murphy
Individual 		Corporate Officer
Board Secretary		 Mar 1, 2021
Christine James
Individual 		Corporate Officer
Board Member		 Oct 1, 2023
Kathleen Cooper
Individual 		Corporate Officer
Board Vice Chair		 Aug 1, 2019
Richard Rogalski
Individual 		Corporate Officer
Board Member		 Sep 1, 2015
Brett Simms
Individual 		Corporate Officer
Board Member		 Nov 1, 2023
Brent L Smith
Individual 		Corporate Director
Ceo		 Apr 1, 2014
Rosemary Bellino Hall
Individual 		Corporate Officer
Board Member		 May 1, 2020
Debra Johnson
Individual 		Corporate Officer
Board Member		 May 1, 2020
Kim Rogalski
Individual 		Corporate Officer
Board Chair		 Aug 1, 2019
Brenda Spencer Ragland
Individual 		Corporate Officer
Board Treasurer		 Jul 1, 2011
Sean McAvoy
Individual 		Corporate Officer Feb 4, 2013
Corporate Director
Senior Director		 Feb 4, 2013
W-2 Managing Employee
Senior Director		 Feb 4, 2013
Margaret Settle
Individual 		Corporate Officer
Board Member		 Mar 1, 2021

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Memorial Health
Lawton, OK · CCN 37T056		 Hospital Operational/Managerial Control Jan 13, 1971
Memorial Health
Lawton, OK · CCN 370056		 Hospital Operational/Managerial Control Jan 13, 1971
McMahon Tomlinson Nursing & Rehabilitation Center
Lawton, OK · CCN 375562		 Skilled nursing facility Operational/Managerial Control Jan 13, 1971
Comanche County Memorial Hospital Home Health Care
Lawton, OK · CCN 377070		 Home health agency Operational/Managerial Control Jan 13, 1971
Comanche County Memorial Hospice and Supportive Care
Lawton, OK · CCN 371713		 Hospice Operational/Managerial Control Jan 13, 1971
Lawton Community Health Center
Lawton, OK · CCN 371846		 Federally qualified health center Operational/Managerial Control Mar 6, 2008
Comanche County Hospital Authority
Lawton, OK · CCN 371962		 Federally qualified health center Operational/Managerial Control Jan 13, 1971
LCHC Medicine Park
Medicine Park, OK · CCN 371975		 Federally qualified health center Operational/Managerial Control Jun 1, 2020
LCHC Family Continuity Clinic
Lawton, OK · CCN 371017		 Federally qualified health center Operational/Managerial Control (100%) Aug 29, 2023
MMG Snyder Family Medical Clinic
Snyder, OK · CCN 373443		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1996

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20180517000834 OK Part a Provider - Federally Qualified Health Center (FQHC) 2668373689 Practice locations: Lawton, OK

National Provider Directory

Tax ID family
Comanche County Hospita (40 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

110 NW 31St St
Suite 201
Lawton, OK 73505-6100

Mailing address

PO Box 2309
Lawton, OK 73502-2309
Phone (580) 357-9984

Other names

  • LCHC Primary Health Care Center at Comanche County Memorial Hospital Doing business as

Other providers in Lawton, OK

All providers in Lawton, OK · Federally Qualified Health Center (FQHC) in Oklahoma

Sources for this page

Verify at the official NPI Registry.