Provider Demographics
NPI:1457692972
Name:COMMUNITY HEALTH CLINIC INC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ZINEB
Authorized Official - Middle Name:A
Authorized Official - Last Name:AMMOUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-871-0011
Mailing Address - Street 1:PO BOX 329
Mailing Address - Street 2:
Mailing Address - City:SHIPSHEWANA
Mailing Address - State:IN
Mailing Address - Zip Code:46565-0329
Mailing Address - Country:US
Mailing Address - Phone:260-593-0108
Mailing Address - Fax:260-593-0116
Practice Address - Street 1:730 E. NORTH STREET
Practice Address - Street 2:
Practice Address - City:SHIPSHEWANA
Practice Address - State:IN
Practice Address - Zip Code:46565
Practice Address - Country:US
Practice Address - Phone:260-593-0108
Practice Address - Fax:260-593-0116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-07
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)Group - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty