| Chiricahua Community Health Centers, Inc | |
|
77 Calle Portal Ste C240 Sierra Vista AZ 85635-2986 | |
| (520) 515-8669 | |
| Not Available |
| Full Name | Chiricahua Community Health Centers, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 77 Calle Portal Ste C240, Sierra Vista, Arizona |
| Authorized Official Name and Position | Daniel Abram Driscoll (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5204593011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chiricahua Community Health Centers, Inc 1100 N F Ave Douglas AZ 85607-1919 Ph: (520) 459-3012 | Chiricahua Community Health Centers, Inc 77 Calle Portal Ste C240 Sierra Vista AZ 85635-2986 Ph: (520) 515-8669 |
| NPI Number | 1205547288 |
|---|---|
| Provider Enumeration Date | 12/09/2022 |
| Last Update Date | 12/09/2022 |
| Medicare PECOS PAC ID | 5395638878 |
|---|---|
| Medicare Enrollment ID | O20230323002549 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205547288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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