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General NPI Number Information
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NPI Number | 1659245470
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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 | 10/03/2025
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 1000 N CURTIS RD STE 203
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City | BOISE
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State | ID
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Zip | 83706-1346
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Country | US
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Telephone | 208-318-1229
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Fax | 208-701-6669
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Provider Business Mailing Address
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Address Line | PO BOX 9 ATTN PHARMACY DIRECTOR -SPECIALTY PHARMACY
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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 | 208-318-1376
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Fax | 208-465-6414
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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