Provider Demographics
NPI:1609287416
Name:COMMUNITY HEALTH AND IMMUNIZATION SERVICES, LLC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH AND IMMUNIZATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMMUNITY DEVELOPMENT
Authorized Official - Prefix:MRS
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 STE 200
Mailing Address - Street 2:SCOTTSDALE
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7801
Mailing Address - Country:US
Mailing Address - Phone:480-646-9031
Mailing Address - Fax:
Practice Address - Street 1:10220 W MARKHAM ST STE 201C
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2183
Practice Address - Country:US
Practice Address - Phone:877-358-8648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty