Provider Demographics
NPI:1821459694
Name:COMMUNITY HEALTHCARE CONSULTANTS LLC
Entity Type:Organization
Organization Name:COMMUNITY HEALTHCARE CONSULTANTS LLC
Other - Org Name:COMMUNITY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HAMMAD
Authorized Official - Middle Name:H
Authorized Official - Last Name:BOKHARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-590-1600
Mailing Address - Street 1:2916 PEACH BLOSSOM DR STE 101
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-8380
Mailing Address - Country:US
Mailing Address - Phone:812-590-1600
Mailing Address - Fax:812-590-6561
Practice Address - Street 1:2916 PEACH BLOSSOM DR STE 101
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-8380
Practice Address - Country:US
Practice Address - Phone:812-590-1600
Practice Address - Fax:812-590-6561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01057661A207Q00000X, 261QP2300X
207Q00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201353880 AMedicaid
KY7100453720Medicaid
IN15D2119413OtherCLIA
IN15D2119413OtherCLIA