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General NPI Number Information
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NPI Number | 1427228212
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTHCARE OF DOUGLAS
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Dates
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Enumeration Date | 03/07/2008
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 2174 W OAK AVE
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City | DOUGLAS
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State | AZ
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Zip | 85607-6003
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Country | US
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Telephone | 520-364-7931
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Fax | 520-364-2551
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Provider Business Mailing Address
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Address Line | 2174 W OAK AVE
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City | DOUGLAS
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State | AZ
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Zip | 85607-6003
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Country | US
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Telephone | 520-364-7931
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Fax | 520-364-2551
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Authorized Official
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Title or Position | CHIEF EXECTUIVE OFFICER
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Name | MR. MICHAEL J CARTER
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Credential |
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Telephone | 520-364-7931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | H-0015
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License Number State | AZ
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