MEDICARE: COMMUNITY HEALTH AND IMMUNIZATION SERVICES, LLC

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
1	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1831501980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH AND IMMUNIZATION SERVICES, LLC

Provider Business Mailing Address
First Line	:	668 N 44TH ST STE 100W
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85008-6507
Country	:	US
Telephone Number	:	844-358-3733
Fax Number	:

Provider Business Practice Location Address
First Line	:	2034 E SOUTHERN AVE STE L
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7511
Country	:	US
Telephone Number	:	844-358-3733
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL BILLING SPECIALIST
Name	:	REBEKAH SUAZO
Credential	:
Telephone Number	:	480-646-9099

Provider Enumeration Date	:	05/23/2014
Last Update Date	:	09/15/2023

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