Covered Entity Details

CAH451382-03 Comanche County Medical Center Company dba Comanche County Medical Center (Active) - information as of 5/11/2025 11:40:18 PM

Main Details

Name

Comanche County Medical Center Company dba Comanche County Medical Center

Subdivision Name

Cornerstone Family Medicine RHC - RHC

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH451382-03

Medicare Provider Number

451382

Outpatient Facility Provider Number

678567

Additional Details

Current Program Status

Active

Registration Date

10/11/2024

Participating Start Date

1/1/2025

Participating Approval Date

10/29/2024

Last Recertification Date

Contacts

Authorizing Official

Comanche County Medical Center
Hong Wade, Chief Financial Officer
(254) 879-4900 Ext: 2215

Primary Contact

Comanche County Medical Center
Sharon Abbey Maxwell, Director of Pharmacy
(254) 879-4961

Addresses

Street Address

408 N. Austin
COMANCHE CO MED CTR COM PHARMACY
Comanche, TX 76442

Billing Address

COMANCHE COUNTY MEDICAL CENTER
10201 HIGHWAY 16 NORTH
COMANCHE CO MED CTR COM PHARMACY
COMANCHE, TX 76442

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
CAH451382-01	Child	CAH	Comanche County Medical Center Company dba Comanche County Medical Center	Rising Star Health Clinic - RHC	1870A State Hwy 36	Rising Star	TX	Active
CAH451382-02	Child	CAH	Comanche County Medical Center Company dba Comanche County Medical Center	Dublin Family Medicine - RHC	305 N. Patrick St.	Dublin	TX	Active
CAH451382-03	Child	CAH	Comanche County Medical Center Company dba Comanche County Medical Center	Cornerstone Family Medicine RHC - RHC	408 N. Austin	Comanche	TX	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		Approved	Active	1/1/2025 12:01 AM
Contacts	Signed By	Insert	New Registration		Wade, Hong Chief Financial Officer Comanche County Medical Center 2548794900-2215	10/29/2024 9:04 AM
Details	340B ID	Update	New Registration		CAH451382-03	10/29/2024 9:04 AM
Details	Entity Name	Update	New Registration	COMANCHE COUNTY MEDICAL CENTER	Comanche County Medical Center Company dba Comanche County Medical Center	10/29/2024 9:04 AM
Details	Entity Subname	Update	New Registration	Cornerstone Family Medicine RHC	Cornerstone Family Medicine RHC - RHC	10/29/2024 9:04 AM
Dates	Participating Approval Date	Update	New Registration		10/29/2024 9:04:06 AM	10/29/2024 9:04 AM
Details	State	Update	New Registration	Pending	Approved	10/29/2024 9:04 AM
Dates	Signed By Date	Update	New Registration		10/28/2024 5:58:30 PM	10/29/2024 9:04 AM
Dates	Start Date	Update	New Registration		1/1/2025 12:00:00 AM	10/29/2024 9:04 AM
Addresses	Main Address	Insert	New Registration		408 N. Austin COMANCHE CO MED CTR COM PHARMACY Comanche, TX 76442	10/11/2024 11:36 AM
Addresses	Billing Address	Insert	New Registration		COMANCHE COUNTY MEDICAL CENTER 10201 HIGHWAY 16 NORTH COMANCHE CO MED CTR COM PHARMACY COMANCHE, TX 76442	10/11/2024 11:36 AM
Contacts	Primary Contact	Insert	New Registration		Maxwell, Sharon Abbey Director of Pharmacy Comanche County Medical Center 2548794961	10/11/2024 11:36 AM
Contacts	Authorizing Official	Insert	New Registration		Wade, Hong Chief Financial Officer Comanche County Medical Center 2548794900-2215	10/11/2024 11:36 AM
Details	Assistance Received From Date	Insert	New Registration			10/11/2024 11:36 AM
Details	Assistance Received To Date	Insert	New Registration			10/11/2024 11:36 AM
Details	Last Recertification Date	Insert	New Registration			10/11/2024 11:36 AM
Details	Grant Number	Insert	New Registration			10/11/2024 11:36 AM
Details	340B ID	Insert	New Registration			10/11/2024 11:36 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/11/2024 11:36 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/11/2024 11:36 AM
Details	Medicare Provider Number	Insert	New Registration		451382	10/11/2024 11:36 AM
Details	Entity Name	Insert	New Registration		COMANCHE COUNTY MEDICAL CENTER	10/11/2024 11:36 AM
Details	NOFO Number	Insert	New Registration			10/11/2024 11:36 AM
Details	Program Code	Insert	New Registration		CAH	10/11/2024 11:36 AM
Details	Entity Subname	Insert	New Registration		Cornerstone Family Medicine RHC	10/11/2024 11:36 AM
Dates	Participating Approval Date	Insert	New Registration			10/11/2024 11:36 AM
Details	State	Insert	New Registration		Pending	10/11/2024 11:36 AM
Dates	Registration Date	Insert	New Registration		10/11/2024 11:36:24 AM	10/11/2024 11:36 AM
Dates	Signed By Date	Insert	New Registration			10/11/2024 11:36 AM
Dates	Start Date	Insert	New Registration			10/11/2024 11:36 AM
Terminations	Termination Comments	Insert	New Registration			10/11/2024 11:36 AM
Terminations	Termination Date	Insert	New Registration			10/11/2024 11:36 AM
Terminations	Termination Effective Date	Insert	New Registration			10/11/2024 11:36 AM
Terminations	Termination Reason	Insert	New Registration			10/11/2024 11:36 AM