| Community Health Care, Inc | |
|
708 15th Ave East Moline IL 61244-2134 | |
| (563) 327-2015 | |
| (563) 327-2045 |
| Full Name | Community Health Care, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 708 15th Ave, East Moline, Illinois |
| Authorized Official Name and Position | Thomas J Bowman (CEO) |
| Authorized Official Contact | 5633363000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Care, Inc 500 W River Dr Davenport IA 52801-1014 Ph: (563) 336-3000 | Community Health Care, Inc 708 15th Ave East Moline IL 61244-2134 Ph: (563) 327-2015 |
| NPI Number | 1477819886 |
|---|---|
| Provider Enumeration Date | 04/10/2012 |
| Last Update Date | 04/29/2013 |
| Medicare PECOS PAC ID | 9830008895 |
|---|---|
| Medicare Enrollment ID | O20120815000452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477819886 | NPI | - | NPPES |
| 1932193224 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Secondary |
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