COMMUNITY HEALTH CARE, INC.; NPI #1710971486

Contact Information

COMMUNITY HEALTH CARE, INC.

1106 4TH AVE
MOLINE, IL 61265-0000

Phone: 563-327-2000
Fax: 563-327-2045
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center
Clinical Medical Laboratory	291U00000X	69	Clinical Laboratory

Indicates primary specialty

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NPI Profile & details for COMMUNITY HEALTH CARE, INC.

NPI Number 1710971486

LBN Legal business name COMMUNITY HEALTH CARE, INC.

Authorized official THOMAS BOWMAN - (CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 09/08/2005

Last updated 04/18/2013 - About 13 years ago

Identifiers

IA	Medicaid	0568998
IA	Other	91681	IA BC/BS GROUP #
IA	Other	I12619	INDEPENDANT LAB
IL	Other	14D1020508	CLIA
IL	Other	8122859	IL BC/BS GROUP#
IL	Other	CP8565	RAILROAD MEDICARE GROUP #
IL	Other	113373	UNITED HEALTH CARE

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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