Organization
CHIRICAHUA COMMUNITY HEALTH CENTERS INC
Active
Other names
Chiricahua Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN P MELK MD (CEO)
(520) 364-6852
Entity
Organization
Contact information
Practice address
155 CALLE PORTAL STE 600, SIERRA VISTA, AZ 85635-2973
(520) 515-8678
(520) 459-8423
Mailing address
1205 N F AVE, DOUGLAS, AZ 85607-1920
(520) 364-1429
(250) 364-4261
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
Y007321
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
296387
—
AZ
Enumeration date
07/03/2017
Last updated
09/01/2021
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