Provider Demographics
NPI:1730445347
Name:COMMUNITY HOSPITAL ASSOCIATION, INC.
Entity type:Organization
Organization Name:COMMUNITY HOSPITAL ASSOCIATION, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:928-684-4390
Mailing Address - Street 1:520 ROSE LN
Mailing Address - Street 2:
Mailing Address - City:WICKENBURG
Mailing Address - State:AZ
Mailing Address - Zip Code:85390-1447
Mailing Address - Country:US
Mailing Address - Phone:928-684-4390
Mailing Address - Fax:928-684-5081
Practice Address - Street 1:700 PALO VERDE ROAD
Practice Address - Street 2:
Practice Address - City:BAGDAD
Practice Address - State:AZ
Practice Address - Zip Code:86321
Practice Address - Country:US
Practice Address - Phone:928-633-6393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation