NPIMap

Organization Active NPI

Comanche County Medical Center Company

Doing business as Rising Star Pharmacy

  • Community/Retail Pharmacy
  • Rising Star, TX
National Provider Identifier
1679174882
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
COMANCHE COUNTY MEDICAL CENTER COMPANY
Doing business as
Rising Star Pharmacy
Practice address
1870 B State Hwy 36
Rising Star, TX 76471
Phone
(254) 643-3231
Fax
(254) 540-5060
NPI assigned
Nov 4, 2020
Last updated
Aug 31, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
COMANCHE COUNTY MEDICAL CENTER COMPANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Hong Wade, CPA
Title
Chief Financial Officer
Phone
(254) 879-4900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

1870 B State Hwy 36
Rising Star, TX 76471

Mailing address

10201 Highway 16
Comanche, TX 76442-4462
Phone (254) 879-4961

Other names 1

  • Rising Star Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191023000362 TX Part B Supplier - Pharmacy 3678753357 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Comanche, TX; Dublin, TX; Rising Star, TX

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Comanche County Med Ctr

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

1870B State Highway 36 W
Rising Star, TX 76471
Phone (254) 643-3231

Practitioners & affiliated clinicians

Practitioners 102

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 102

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1679174882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 HIGHWAY 16",
            "city": "COMANCHE",
            "state": "TX",
            "postal_code": "764424462",
            "telephone_number": "254-879-4961",
            "fax_number": "254-879-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 B STATE HWY 36",
            "city": "RISING STAR",
            "state": "TX",
            "postal_code": "76471",
            "telephone_number": "254-643-3231",
            "fax_number": "254-540-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY MEDICAL CENTER COMPANY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMANCHE COUNTY MEDICAL CENTER COMPANY",
        "enumeration_date": "2020-11-04",
        "last_updated": "2021-08-31",
        "certification_date": "2021-02-11",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "HONG",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "254-879-4900",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rising Star Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rising Star Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rising Star, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.