Provider Demographics
NPI:1295147759
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:877-358-8648
Mailing Address - Fax:
Practice Address - Street 1:2435 KIMBERLY RD STE 140
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3509
Practice Address - Country:US
Practice Address - Phone:515-393-3409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-02
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty