Basic Information
| Provider Information | |||||||||
| NPI: | 1184968802 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COMMUNITY HEALTH DEVELOPMENT, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 908 EVANS ST | ||||||||
| Address2: | |||||||||
| City: | UVALDE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 788016051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8302785604 | ||||||||
| FaxNumber: | 8302790775 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 EVANS ST | ||||||||
| Address2: | |||||||||
| City: | UVALDE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8302785604 | ||||||||
| FaxNumber: | 8302781836 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2012 | ||||||||
| LastUpdateDate: | 09/28/2016 | ||||||||
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| AuthorizedOfficialLastName: | GONZALES-HANSON | ||||||||
| AuthorizedOfficialFirstName: | RACHEL | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF EXECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 8302785604 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336C0003X | Y | Suppliers | Pharmacy | Community/Retail Pharmacy |
No ID Information.