Organization
COMMUNITY HEALTH CARE, INC.
Active
Other names
Community Health Care - Regional Virology
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS J BOWMAN (CEO)
(563) 336-3000
Entity
Organization
Contact information
Practice address
1351 W CENTRAL PARK AVE, DAVENPORT, IA 52804-1853
(563) 421-4244
(563) 421-4285
Mailing address
500 W RIVER DR, DAVENPORT, IA 52801-1014
(563) 336-3000
(563) 336-3044
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0418517
—
IA
01
—
113373
UNITED HEALTHCARE
IA
01
—
16D1035713
CLIA #
IA
01
—
39110
IA BC/BS GROUP#
IA
01
—
8122859
IL BC/BS GROUP #
IL
01
—
CP8565
RAILROAD MEDICARE GROUP #
IA
01
—
I12619
INDEPENDANT LAB
IA
Enumeration date
09/08/2005
Last updated
06/15/2010
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