Healthcare Provider Details

I. General information

NPI: 1356149694
Provider Name (Legal Business Name): COMMUNITY HEALTH CLINICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 03/04/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W MAIN ST
MARSING ID
83639
US

IV. Provider business mailing address

PO BOX 9 C/O PHARMACY DIRECTOR, MARSING -RETAIL
NAMPA ID
83653-0009
US

V. Phone/Fax

Practice location:
  • Phone: 208-896-4150
  • Fax: 208-318-1357
Mailing address:
  • Phone: 208-896-4150
  • Fax: 208-318-1357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HOLLY HENGGELER
Title or Position: PHARMACY DIRECTOR
Credential: PHARMD
Phone: 208-318-1315