Provider Demographics
NPI:1700866605
Name:COMMUNITY HEALTH CARE, INC.
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CARE, INC.
Other - Org Name:CHC-ADULT REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-336-3000
Mailing Address - Street 1:500 W RIVER DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52801-1014
Mailing Address - Country:US
Mailing Address - Phone:563-336-3000
Mailing Address - Fax:563-336-3044
Practice Address - Street 1:4001 N BRADY ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-4003
Practice Address - Country:US
Practice Address - Phone:563-336-3000
Practice Address - Fax:563-336-3044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA113373OtherUNITED HEALTHCARE
IA13238OtherIA BC/BS GROUP#
IA0080200Medicaid
IL8122859OtherIL BC/BS GROUP#
IACP8565OtherRAIL ROAD MEDICARE GROUP
IACP8565OtherRAIL ROAD MEDICARE GROUP
IA0080200Medicaid
IL=========006OtherMEDICAID FQHC
IL8122859OtherIL BC/BS GROUP#
IA161824Medicare Oscar/Certification