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NPI Code Detail

MEDICARE: COMMUNITY HEALTH CARE, INC.

MEDICARE: COMMUNITY HEALTH CARE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory
2261QF0400XFederally Qualified Health Center (FQHC)

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5CP8565OTHERILRAILROAD MEDICARE GROUP #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
192912OTHERIAIA BC/BS GROUP #
214D1020507OTHERILCLIA #
3113373OTHERILUNITED HEALTHCARE
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
68122859OTHERILIL BC/BS GROUP #
7I12619OTHERIAINDEPENTANT LAB

General Provider Information

NPI Number : 1598759292
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY HEALTH CARE, INC.
Provider Business Mailing Address
First Line : 500 W RIVER DR
Second Line :
City : DAVENPORT
State : IA
Zip : 52801-1014
Country : US
Telephone Number : 563-336-3000
Fax Number : 563-336-3044
Provider Business Practice Location Address
First Line : 2750 11TH ST
Second Line :
City : ROCK ISLAND
State : IL
Zip : 61201-5216
Country : US
Telephone Number : 563-327-2100
Fax Number : 563-327-2102
Authorized Official
Title or Position : CEO
Name : THOMAS J BOWMAN
Credential :
Telephone Number : 563-336-3000
Provider Enumeration Date : 09/08/2005
Last Update Date : 04/18/2013

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Directions to “COMMUNITY HEALTH CARE, INC. ” Practice Location

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