Provider Demographics
NPI:1003229295
Name:COMMUNITY HEALTH AND IMMUNIZATION SERVICES
Entity Type:Organization
Organization Name:COMMUNITY HEALTH AND IMMUNIZATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMMUNITY DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-646-9031
Mailing Address - Street 1:8324 E HARTFORD DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5466
Mailing Address - Country:US
Mailing Address - Phone:877-358-8646
Mailing Address - Fax:
Practice Address - Street 1:10730 PACIFIC ST
Practice Address - Street 2:SUITE 221 B
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4799
Practice Address - Country:US
Practice Address - Phone:402-715-9308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19357172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty