NPIMap

Organization Active NPI

Chiricahua Community Health Centers Inc

  • Pharmacy
  • Benson, AZ
National Provider Identifier
1437651288
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
Y007570 Issued in AZ
Legal business name
CHIRICAHUA COMMUNITY HEALTH CENTERS INC
Practice address
335 S Ocotillo Avenue
Benson, AZ 85602
Phone
(520) 586-4699
Fax
(520) 586-4691
NPI assigned
Mar 7, 2018
Last updated
Sep 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jonathan P Melk
Title
Pharmacy Manager
Phone
(520) 364-6852

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Y007570 AZ Primary

Addresses

Primary practice location

335 S Ocotillo Avenue
Benson, AZ 85602

Mailing address

1205 F Ave
Douglas, AZ 85607-1920
Phone (520) 364-6852

Other identifiers 1

IdentifierTypeStateIssuer
401006MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171004002943 AZ Part B Supplier - Pharmacy 5395638878 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Benson, AZ; Sierra Vista, AZ

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Chiricahua Community He22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1437651288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 F AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071920",
            "telephone_number": "520-364-6852",
            "fax_number": "520-364-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 S OCOTILLO AVENUE",
            "city": "BENSON",
            "state": "AZ",
            "postal_code": "85602",
            "telephone_number": "520-586-4699",
            "fax_number": "520-586-4691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRICAHUA COMMUNITY HEALTH CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-07",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "MELK",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "520-364-6852"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AZ",
            "license": "Y007570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401006",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.