Organization
SOUTH-WEST COMMUNITY HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOLLIE MELBOURNE (PRESIDENT CEO)
(203) 332-3501
Entity
Organization
Contact information
Practice address
46 ALBION ST, BRIDGEPORT, CT 06605-2602
(203) 330-6000
(203) 330-6008
Mailing address
46 ALBION ST, BRIDGEPORT, CT 06605-2602
(203) 330-6000
(203) 382-1436
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
0032
CT
207VG0400X
Gynecology Physician
0454
CT
207VX0000X
Obstetrics Physician
0032
CT
207VX0000X
Obstetrics Physician
0454
CT
261QF0400X
Federally Qualified Health Center (FQHC)
0032
CT
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
0032
CT
261QP2300X
Primary Care Clinic/Center
0032
CT
261QP2300X
Primary Care Clinic/Center
0454
CT
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236122
—
CT
05
—
004236130
—
CT
05
—
004236148
—
CT
Enumeration date
06/29/2006
Last updated
04/28/2022
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