| NPI | 1518613215 |
|---|---|
| Doing Business As | COMMUNITY HEALTH NORTH MAIN ST |
| Entity Type | Organization |
| Authorized Contact | MELISSA BOVEY Credentialing Specialist 800-468-9118 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2022-02-22 |
| Last Update Date | 2022-04-07 |