Organization
COMMUNITY HEALTH CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BAIN PATRIE (CREDENTIALING SPECIALIST)
(860) 347-6971
Entity
Organization
Contact information
Practice address
635 MAIN ST, MIDDLETOWN, CT 06457-2718
(860) 347-6971
(860) 638-6601
Mailing address
635 MAIN ST, ATTN: CREDENTIALING DEPARTMENT, MIDDLETOWN, CT 06457-2718
(860) 347-6971
(860) 638-6601
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0392
CT
207R00000X
Internal Medicine Physician
0392
CT
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
0392
CT
213E00000X
Podiatrist
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
06/10/2006
Last updated
07/23/2007
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