Chiricahua Community Health Centers, Inc | |
77 Calle Portal Ste C240 Sierra Vista AZ 85635-2986 | |
(520) 515-8669 | |
Not Available |
Full Name | Chiricahua Community Health Centers, Inc |
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Speciality | Clinic/Center |
Location | 77 Calle Portal Ste C240, Sierra Vista, Arizona |
Authorized Official Name and Position | Daniel Abram Driscoll (AUTHORIZED OFFICIAL) |
Authorized Official Contact | 5204593011 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Chiricahua Community Health Centers, Inc 1100 N F Ave Douglas AZ 85607-1919 Ph: (520) 459-3012 | Chiricahua Community Health Centers, Inc 77 Calle Portal Ste C240 Sierra Vista AZ 85635-2986 Ph: (520) 515-8669 |
NPI Number | 1205547288 |
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Provider Enumeration Date | 12/09/2022 |
Last Update Date | 12/09/2022 |
Medicare PECOS PAC ID | 5395638878 |
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Medicare Enrollment ID | O20230323002549 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205547288 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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