Provider Demographics
NPI:1639556038
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:MEDICAL BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-646-9099
Mailing Address - Street 1:668 N 44TH ST STE 100W
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-6507
Mailing Address - Country:US
Mailing Address - Phone:844-358-3733
Mailing Address - Fax:
Practice Address - Street 1:4610 NE 77TH AVE
Practice Address - Street 2:STE. 133B
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6789
Practice Address - Country:US
Practice Address - Phone:480-646-9031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-05
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty