COMMUNITY HEALTH CARE INC. NPI 1962496679

NPI Information

NPI: 1962496679
Provider Name: COMMUNITY HEALTH CARE, INC.

Other Name: COMMUNITY HEALTH CARE - REGIONAL VIROLOGY

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
1351 W CENTRAL PARK AVE
DAVENPORT, IA
ZIP 52804
Phone: (563) 421-4244
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COMMUNITY HEALTH CARE, INC. is a federally qualified health center (fqhc) clinic center in Davenport, IA. COMMUNITY HEALTH CARE, INC. NPI is 1962496679. The provider is registered as an organization entity type.
The provider Other Name Is Community Health Care - Regional Virology.

The provider's business location address is:

1351 W CENTRAL PARK AVE
DAVENPORT, IA
ZIP 52804-853
Phone: (563) 421-4244
Fax: (563) 421-4285

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 9/8/2005 and was last updated on 6/15/2010.

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	291U00000X	Clinical Medical Laboratory				No
2	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	0418517	MEDICAID	IOWA
2	39110	OTHER	IOWA	IA BC/BS GROUP#
3	161822	MEDICARE OSCAR/CERTIFICATION	IOWA
4	13238	MEDICARE PIN	IOWA
5	I12619	OTHER	IOWA	INDEPENDANT LAB
6	CP8565	OTHER	IOWA	RAILROAD MEDICARE GROUP #
7	113373	OTHER	IOWA	UNITED HEALTHCARE
8	16D1035713	OTHER	IOWA	CLIA #
9	=========007	MEDICAID	ILLINOIS
10	8122859	OTHER	ILLINOIS	IL BC/BS GROUP #
11	=========	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: 4/28/2024

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