Organization
CHIRICAHUA COMMUNITY HEALTH CENTERS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN P MELK MD (CEO)
(520) 364-1429
Entity
Organization
Contact information
Practice address
815 15TH STREET, DOUGLAS, AZ 85607
(520) 364-5437
(520) 364-4261
Mailing address
1205 F. AVENUE, DOUGLAS, AZ 85607
(520) 364-1429
(520) 364-4261
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
OTC5111
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
945141
—
AZ
Enumeration date
02/15/2011
Last updated
09/01/2021
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