Organization
COMMUNITY HEALTHCARE OF DOUGLAS INC
Active
Other names
Community Healthcare of Douglas Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J CARTER (CHIEF EXECUTIVE OFFICER)
(520) 364-7931
Entity
Organization
Contact information
Practice address
2174 W OAK AVE, DOUGLAS, AZ 85607-6003
(520) 364-7931
(520) 364-2551
Mailing address
2174 W OAK AVE, DOUGLAS, AZ 85607-6003
(520) 364-7931
(520) 364-2551
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
H-0015
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033995
MEDICARE/OTHER
AZ
Enumeration date
04/09/2007
Last updated
05/29/2008
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