In Ireland, the phone company had small exchanges all around the country. In the bigger towns/cities they would have a number of larger exchanges in different areas.
They all still exist but have fibre interlinking them and now they would have fibre to the home for broadband and would have the phones ( if anyone still has one) off the modem. We rarely use copper lines anymore, most lines are sip or hosted system using sip/IP phones over the broadband