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General NPI Number Information
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NPI Number | 1992501498
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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 | 300 S 23RD ST
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City | BOISE
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State | ID
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Zip | 83702-9100
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Country | US
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Telephone | 208-318-1396
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Fax | 208-803-0214
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Provider Business Mailing Address
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Address Line | PO BOX 9 C/O PHARMACY DIRECTOR, BOISE -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 | 208-318-1396
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Fax | 208-803-0214
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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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