Organization
COMMUNITY HEALTH AND IMMUNIZATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBEKAH SUAZO (MEDICAL BILLING SUPERVISOR)
(480) 646-9099
Entity
Organization
Contact information
Practice address
401A S VAN BRUNT ST, SUITE 202B, ENGLEWOOD, NJ 07631-4600
(201) 603-9996
Mailing address
668 N 44TH ST STE 100W, PHOENIX, AZ 85008-6507
(877) 358-8646
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
25MB05677400
NJ
Other
Enumeration date
06/05/2014
Last updated
10/08/2021
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