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General NPI Number Information
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NPI Number | 1528269131
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Entity Type | Organization
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Legal Business Name | SOUTHWEST COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 46 ALBION ST
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City | BRIDGEPORT
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State | CT
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Zip | 06605-2602
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Country | US
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Telephone | 203-330-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 46 ALBION ST
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City | BRIDGEPORT
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State | CT
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Zip | 06605-2602
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Country | US
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Telephone | 203-330-6000
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Fax | 203-330-6008
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. MOLLIE L MELBOURNE
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Credential |
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Telephone | 203-330-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 0032
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License Number State | CT
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