Provider Demographics
NPI:1770097123
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:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:TAVARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-684-5421
Mailing Address - Street 1:523 ROSE LN
Mailing Address - Street 2:
Mailing Address - City:WICKENBURG
Mailing Address - State:AZ
Mailing Address - Zip Code:85390-1448
Mailing Address - Country:US
Mailing Address - Phone:928-668-1845
Mailing Address - Fax:
Practice Address - Street 1:32919 N CENTER ST STE B
Practice Address - Street 2:
Practice Address - City:WITTMANN
Practice Address - State:AZ
Practice Address - Zip Code:85361-9433
Practice Address - Country:US
Practice Address - Phone:928-668-1833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HOSPITAL ASSOCIATION, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health