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NPI 1487450987

NPI 1487450987 : COMMUNITY HEALTH CLINICS, INC. : CALDWELL, ID

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General NPI Number Information
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    NPI Number           |    1487450987
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    Entity Type          |    Organization 
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    Legal Business Name  |    COMMUNITY HEALTH CLINICS, INC. 
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Dates
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    Enumeration Date     |    02/24/2025
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    Last Update Date     |    02/24/2025
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Provider Practice Location Address
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    Address Line         |    808 CLEVELAND BLVD 
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    City                 |    CALDWELL
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    State                |    ID
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    Zip                  |    83605-4168
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    Country              |    US
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    Telephone            |    208-318-1334
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    Fax                  |    208-747-8024
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Provider Business Mailing Address
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    Address Line         |    PO BOX 9 C/O PHARMACY DIRECTOR, CALDWELL -RETAIL
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    City                 |    NAMPA
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    State                |    ID
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    Zip                  |    83653-0009
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    Country              |    US
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    Telephone            |    208-318-1334
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    Fax                  |    208-747-8024
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Authorized Official
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    Title or Position    |    PHARMACY DIRECTOR
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    Name                 |     HOLLY  HENGGELER 
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    Credential           |    PHARMD
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    Telephone            |    208-318-1315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    
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    License Number State |    
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