| Organization Name: | COMMUNITY HEALTHCARE OF DOUGLAS INC |
| NPI Number: | 1033319512 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL J CARTER (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 1906 11th Street Douglas |
| State: | AZ US |
| Postal Code: | 85607 |
| Phone Number: | 5203641120 |
| Fax Number: | 2503646417 |
| NPI Enumeration Date: | 07/23/2007 |
| NPI Last Update Date: | 06/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC0050X |
| License Number: | H-0015 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Critical Access Hospital |
| Taxonomy Definition: | An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified. |