Organization
COMMUNITY HEALTH CARE, INC.
Active
Other names
Community Health Care, Inc. Outreach Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS J BOWMAN (CEO)
(563) 336-3000
Entity
Organization
Contact information
Practice address
902 W 4TH ST, DAVENPORT, IA 52802-3507
(563) 336-3000
(563) 336-3125
Mailing address
500 W RIVER DR, DAVENPORT, IA 52801-1014
(563) 336-3000
(563) 336-3044
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0080200
—
IA
01
—
113373
UNITED HEALTHCARE
IA
01
—
13238
IA BC/BS GROUP#
IA
01
—
8122859
IL BC/BS
IL
01
—
=========
BILLING TAX ID# FOR CHC
IA
05
—
=========
—
IL
01
—
CP8565
RAILROAD MEDICARE GROUP #
IA
Enumeration date
01/17/2006
Last updated
03/25/2024
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