MEDICARE: COMMUNITY BRIDGES, 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
1	291U00000X	Clinical Medical Laboratory	03D2036661	AZ

General Provider Information

NPI Number	:	1841556073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY BRIDGES, INC.

Provider Business Mailing Address
First Line	:	1855 W BASELINE RD
Second Line	:	SUITE 101
City	:	MESA
State	:	AZ
Zip	:	85202-9000
Country	:	US
Telephone Number	:	480-831-7566
Fax Number	:	480-962-7671

Provider Business Practice Location Address
First Line	:	4225 W GLENDALE AVE
Second Line	:	SUITE 100A
City	:	PHOENIX
State	:	AZ
Zip	:	85051-8194
Country	:	US
Telephone Number	:	623-931-1557
Fax Number	:	632-931-2013

Authorized Official
Title or Position	:	VP/COO
Name	:	JOHN HOGEBOOM
Credential	:	LISAC
Telephone Number	:	480-831-7566

Provider Enumeration Date	:	04/02/2012
Last Update Date	:	04/02/2012

Similar Medicare Providers

1568313955 — ENAS MEDICAL TRANSPORT LLC
Practice Location Address:

4225 W GLENDALE AVE STE B102
PHOENIX, AZ
85051-8194

Practice Phone: 623-313-3909
Practice Fax:

1750486114 — MARK AUSTEIN MD
Practice Location Address:

4225 W GLENDALE AVE , SUITE E119
PHOENIX, AZ
85051-8194

Practice Phone: 623-915-0294
Practice Fax:

1942420419 — MOISE JOSEPH MD
Practice Location Address:

4225 W GLENDALE AVE , E119
PHOENIX, AZ
85051-8194

Practice Phone: 623-915-0270
Practice Fax: 623-915-4837

1356576334 — HUMAIRA SHAFI M.D.
Practice Location Address:

4225 W GLENDALE AVE , SUITE B 200
PHOENIX, AZ
85051-8194

Practice Phone: 623-934-5600
Practice Fax: 623-934-5603

1013241314 — ARIZONA MEDICAL EQUIPMENT & SUPPLY LLC
Practice Location Address:

4225 W GLENDALE AVE , C106
PHOENIX, AZ
85051-8194

Practice Phone: 623-266-7255
Practice Fax: 623-266-7254

1932859600 — ICAN HEALTH CARE & SERVICES LLC
Practice Location Address:

4225 W GLENDALE AVE , SUITE A-100/101
PHOENIX, AZ
85051-8194

Practice Phone: 480-851-8323
Practice Fax: 623-207-9564

Directions to “COMMUNITY BRIDGES, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.