MEDICARE: COMMUNITY HEALTHCARE CONSULTANTS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	01057661A	IN
2	207Q00000X	Family Medicine Physician
3	363L00000X	Nurse Practitioner
4	261QP2300X	Primary Care Clinic/Center	01057661A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	15D2119413	OTHER	IN	CLIA

General Provider Information

NPI Number	:	1821459694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTHCARE CONSULTANTS LLC

Provider Business Mailing Address
First Line	:	2916 PEACH BLOSSOM DR STE 101
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-8380
Country	:	US
Telephone Number	:	812-590-1600
Fax Number	:	812-590-6561

Provider Business Practice Location Address
First Line	:	2916 PEACH BLOSSOM DR STE 101
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-8380
Country	:	US
Telephone Number	:	812-590-1600
Fax Number	:	812-590-6561

Authorized Official
Title or Position	:	MEMBER
Name	:	HAMMAD H. BOKHARI
Credential	:	M.D.
Telephone Number	:	812-590-1600

Provider Enumeration Date	:	03/08/2016
Last Update Date	:	10/01/2020

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Directions to “COMMUNITY HEALTHCARE CONSULTANTS LLC ” Practice Location

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