Healthcare Provider Details

I. General information

NPI: 1780300418
Provider Name (Legal Business Name): COMMUNITY HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2022
Last Update Date: 10/14/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 4TH AVE
MOLINE IL
61265-1231
US

IV. Provider business mailing address

500 W RIVER DR
DAVENPORT IA
52801-1014
US

V. Phone/Fax

Practice location:
  • Phone: 563-336-3000
  • Fax: 563-327-2045
Mailing address:
  • Phone: 563-336-3000
  • Fax: 563-336-3125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: THOMAS BOWMAN
Title or Position: CEO
Credential: CEO
Phone: 563-336-3000