NPIMap

Organization Active NPI

Chiricahua Community Health Centers, Inc.

Doing business as Chiricahua Bisbee Pharmacy

  • Pharmacy
  • Bisbee, AZ
National Provider Identifier
1447725783
Registry record updated Mar 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
CHIRICAHUA COMMUNITY HEALTH CENTERS, INC.
Doing business as
Chiricahua Bisbee Pharmacy
Practice address
307 Arizona St
Bisbee, AZ 85603-1501
Phone
(520) 432-4660
Fax
(520) 432-1140
NPI assigned
Oct 12, 2018
Last updated
Mar 22, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2019

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

Authorized official

Name
Jonathan Paul Melk, MDNPI 1568496164
Title
Ceo
Phone
(520) 364-1429

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

307 Arizona St
Bisbee, AZ 85603-1501

Mailing address

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

Other names 1

  • Chiricahua Bisbee Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181218003453 AZ Part B Supplier - Pharmacy 5395638878 1 other NPI on this enrollment
Practice locations: Bisbee, AZ; Douglas, AZ

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

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

Locations

307 Arizona St
Bisbee, AZ 85603
Phone (520) 432-4660

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1539302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553212800000",
    "number": "1447725783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 N 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": "307 ARIZONA ST",
            "city": "BISBEE",
            "state": "AZ",
            "postal_code": "856031501",
            "telephone_number": "520-432-4660",
            "fax_number": "520-432-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRICAHUA COMMUNITY HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-12",
        "last_updated": "2019-03-22",
        "status": "A",
        "authorized_official_last_name": "MELK",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "520-364-1429",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chiricahua Bisbee Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chiricahua Bisbee Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bisbee, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; 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.