COMMUNITY HEALTH CARE INC. NPI 1124008214

NPI Information

NPI: 1124008214
Provider Name: COMMUNITY HEALTH CARE, INC.

Doing Business As: COMMUNITY HEALTH CARE, INC. OUTREACH CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
902 W 4TH ST
DAVENPORT, IA
ZIP 52802
Phone: (563) 336-3000
Get Directions

COMMUNITY HEALTH CARE, INC. is a federally qualified health center (fqhc) clinic center in Davenport, IA. COMMUNITY HEALTH CARE, INC. NPI is 1124008214. The provider is registered as an organization entity type.
The provider Is Doing Business As Community Health Care, Inc. Outreach Clinic.

The provider's business location address is:

902 W 4TH ST
DAVENPORT, IA
ZIP 52802-507
Phone: (563) 336-3000
Fax: (563) 336-3125

The provider's authorized official is Thomas J Bowman .
The authorized official title is Ceo and has the following contact phone number (563) 336-3000.

The enumeration date for this NPI number is 1/17/2006 and was last updated on 3/25/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	113373	OTHER	IOWA	UNITED HEALTHCARE
2	13238	OTHER	IOWA	IA BC/BS GROUP#
3	0080200	MEDICAID	IOWA
4	8122859	OTHER	ILLINOIS	IL BC/BS
5	=========	MEDICAID	ILLINOIS
6	CP8565	OTHER	IOWA	RAILROAD MEDICARE GROUP #
7	=========	OTHER	IOWA	BILLING TAX ID# FOR CHC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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