Healthcare Provider Details

I. General information

NPI: 1245643402
Provider Name (Legal Business Name): COMMUNITY HEALTH AND IMMUNIZATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4343 E OUTLIER BLVD STE 100W
PHOENIX AZ
85008-6540
US

IV. Provider business mailing address

4343 E OUTLIER BLVD STE 100W
PHOENIX AZ
85008-6540
US

V. Phone/Fax

Practice location:
  • Phone: 844-358-3733
  • Fax:
Mailing address:
  • Phone: 877-358-3733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL C HAYMORE
Title or Position: BILLING MANAGER
Credential:
Phone: 480-464-9030