| Chiricahua Community Health Centers, Inc | |
|
1100 F Ave Douglas AZ 85607-1919 | |
| (520) 364-3285 | |
| (520) 364-3378 |
| Full Name | Chiricahua Community Health Centers, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1100 F Ave, Douglas, Arizona |
| Authorized Official Name and Position | Jonathan P Melk (CEO) |
| Authorized Official Contact | 5203641429 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chiricahua Community Health Centers, Inc 1205 F Ave Douglas AZ 85607-1920 Ph: (520) 364-6852 | Chiricahua Community Health Centers, Inc 1100 F Ave Douglas AZ 85607-1919 Ph: (520) 364-3285 |
| NPI Number | 1801821970 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 09/01/2021 |
| Medicare PECOS PAC ID | 5395638878 |
|---|---|
| Medicare Enrollment ID | O20170117001934 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801821970 | NPI | - | NPPES |
| 945132 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | OTC3057 (Arizona) | Primary |
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Chiricahua Community Health Centers, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 815 15th Street, Douglas, AZ 85607 Phone: 520-364-5437 Fax: 520-364-4261 | |
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