NPIMap

Organization Active NPI

Community Bridges, Inc

Doing business as CAsa Grande Outp Services

  • Clinical Medical Laboratory
  • Casa Grande, AZ
National Provider Identifier
1922364157
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
03D2036422 Issued in AZ
Legal business name
COMMUNITY BRIDGES, INC
Doing business as
CAsa Grande Outp Services
Practice address
675 E Cottonwood LN
Suite 101
Casa Grande, AZ 85122-2032
Phone
(520) 426-0088
NPI assigned
Apr 2, 2012
Last updated
Apr 2, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY BRIDGES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
Mr. John Hogeboom, LISAC
Title
VP/Coo
Phone
(480) 831-7566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 03D2036422 AZ Primary

Addresses

Primary practice location

675 E Cottonwood LN
Suite 101
Casa Grande, AZ 85122-2032

Mailing address

1855 W Baseline Rd
Suite 101
Mesa, AZ 85202-9000
Phone (480) 831-7566

Other names 1

  • CAsa Grande Outp Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Bridges66 organizations share this tax ID, including this one
Part of
Community Bridges

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1922364157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 W BASELINE RD",
            "address_2": "SUITE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852029000",
            "telephone_number": "480-831-7566",
            "fax_number": "480-962-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 E COTTONWOOD LN",
            "address_2": "SUITE 101",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851222032",
            "telephone_number": "520-426-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY BRIDGES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY BRIDGES, INC",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "HOGEBOOM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VP/COO",
        "authorized_official_telephone_number": "480-831-7566",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LISAC"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AZ",
            "license": "03D2036422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAsa Grande Outp Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.