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Contact Information

COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA INC
951 BROADWAY ST
HAMILTON, IL62341-1436
 Phone: 217-847-2112
 Fax: 319-753-2301
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA INC

NPI # 1992784300
LBN Legal business name COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA INC
Authorized official ANTONIO FLORES - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 01/13/2006
Last updated 01/25/2023 - About 3 years ago
Identifiers
IA Medicaid 0563890
MO Medicaid 506089416
IL Other 3422957 BLUE CROSS BLUE SHIELD
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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