Provider Demographics
NPI:1013569961
Name:COMMUNITY HEALTH CONNECTION, INC.
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CONNECTION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-622-0641
Mailing Address - Street 1:2321 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-1831
Mailing Address - Country:US
Mailing Address - Phone:918-710-4403
Mailing Address - Fax:
Practice Address - Street 1:13702 E 46TH PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74134-5919
Practice Address - Country:US
Practice Address - Phone:918-622-0641
Practice Address - Fax:918-622-4814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)