# COMMUNITY HOSPITAL ASSOCIATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COMMUNITY HOSPITAL ASSOCIATION
- **Other names:** Fairfax Family Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1689183881
- **Legal business name:** COMMUNITY HOSPITAL ASSOCIATION
- **Authorized official:** JON P DAVIS (CFO)
- **Authorized official phone:** (660) 686-2320

## Contact information

- **Practice address:** 309 E MAIN ST, FAIRFAX, MO 64446-9312
- **Practice address phone:** (660) 686-0263
- **Practice address fax:** (660) 686-0262
- **Mailing address:** 26136 US HIGHWAY 59, FAIRFAX, MO 64446-9105
- **Mailing address phone:** (660) 686-2211
- **Mailing address fax:** (660) 686-2618

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/20/2017
- **Last updated:** 10/22/2019