Organization
CHIRICAHUA COMMUNITY HEALTH CENTERS, INC.
Active
Other names
Chiricahua Douglas Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN P MELK MD (CEO)
(520) 364-1429
Entity
Organization
Contact information
Practice address
1111 N F AVE, DOUGLAS, AZ 85607-1918
(520) 364-6860
Mailing address
1205 N F AVE, DOUGLAS, AZ 85607-1920
(520) 364-6852
(520) 364-4261
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
527724
—
AZ
Enumeration date
04/18/2019
Last updated
09/01/2021
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