COMMUNITY HEALTH CENTER OF LUBBOCK, INC. (NPI# 1225304686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225304686 |
| Entity Type | Organization |
| Organization Name | COMMUNITY HEALTH CENTER OF LUBBOCK, INC. |
| Other Organization Name | CHCL WEST MEDICAL & DENTAL CLINIC |
| Practice Address |
5424 19th St Ste 200 Lubbock TX 79407 |
| Mailing Address |
1610 5th St Lubbock TX 79401-2622 |
| Practice Telephone | 8067224453 |
| Mailing Telephone | 8067652611 |
| Mailing Fax Number | 8066875826 |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2018-05-29 |
| Authorized Official Name | MR. MICHAEL P. SULLIVAN (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 8067652611 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| CHCL West Medical & Dental Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831569540 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3502 9th St Ste 280, Lubbock, TX 79415 | 2015-10-07 |
| 1740551787 | Community Health Center of Lubbock, Inc. | Clinic/Center | 2401 Fulton Ave Apt B, Lubbock, TX 79407-7727 | 2012-01-23 |
| 1912944059 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3301 Clovis Road, Lubbock, TX 79415 | 2006-05-31 |
| 1528030087 | Community Health Center of Lubbock, Inc. | Clinic/Center | 2301 Cedar Ave, Lubbock, TX 79404 | 2006-02-07 |
| 1053845297 | Community Health Center of Lubbock, Inc. | Counselor | 1610 5th St, Lubbock, TX 79401-2622 | 2017-04-14 |
| 1023274172 | Community Health Center of Lubbock, Inc. | Clinic/Center | 1318 Broadway, Lubbock, TX 79401-3206 | 2008-07-29 |
| 1720247125 | Community Health Center of Lubbock, Inc. | Clinic/Center | 1313 Broadway, Suite 5, Lubbock, TX 79401-3277 | 2008-06-02 |
| 1689855819 | Community Health Center of Lubbock, Inc. | Clinic/Center | 1313 Broadway, Suite 5, Lubbock, TX 79401-3277 | 2007-11-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY HEALTH CENTER OF LUBBOCK, INC., THE | 1610 5th St, Lubbock, TX 79401-2622 |
| Street Address |
5424 19TH ST STE 200 |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275155731 | Bryce Olson Pt, LLC | Physical Therapist | 6014 45th St Ste C Lubbock, Tx 79407, 6014 45th St Ste C Lubbock, Tx 79407, Lubbock, TX 79407 | 2020-05-07 |
| 1235762923 | Fnu Sindhuja Gunasekaran | Physical Therapist | 6014 45th Street, Lubbock, TX 79407 | 2020-02-20 |
| 1770987554 | Amanda Moore | Occupational Therapist | 6548 43rd St, Lubbock, TX 79407 | 2014-10-22 |
| 1336565639 | Best Eye Visioncare, Pllc | Optometrist | 6020 34th Street, Lubbock, TX 79407 | 2014-03-11 |
| 1003249210 | Costco Wholesale Corporation | Pharmacy | 6020 34th St, Lubbock, TX 79407 | 2013-08-12 |
| 1023385879 | Medway Medical Equipment IIi LLC | Durable Medical Equipment & Medical Supplies | 3448 W Loop 289, Lubbock, TX 79407 | 2011-11-22 |
| 1801102553 | Jennifer Hobbs Williams | Nurse Practitioner | 1910 Quaker Ave Ste 101, Lubbock, TX 79407 | 2010-08-19 |
| 1780901496 | Joni Rodriguez | Counselor | 1611 Ave K, Lubbock, TX 79407 | 2010-04-21 |
| 1073776860 | Southwest Regional PCr, LLC | Clinical Medical Laboratory | 2002 W Loop 289 Ste 116, Lubbock, TX 79407 | 2008-07-02 |
| 1740464288 | Jennifer Merle Ezell | Nurse Practitioner | 5219 City Bank Parkway, Ste. 35, Lubbock, TX 79407 | 2007-12-19 |
| Find all providers in zip 79407 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831569540 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3502 9th St Ste 280, Lubbock, TX 79415 | 2015-10-07 |
| 1750702015 | Texas Tech University Health Sciences Center Son | Clinic/Center | 2424 50th St Rm 300, Lubbock, TX 79412-2561 | 2014-01-03 |
| 1740551787 | Community Health Center of Lubbock, Inc. | Clinic/Center | 2401 Fulton Ave Apt B, Lubbock, TX 79407-7727 | 2012-01-23 |
| 1831118306 | Community Health Center of Lubbock, Inc | Clinic/Center | 1826 Parkway Dr, Suite 500, Lubbock, TX 79403 | 2006-07-18 |
| 1912944059 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3301 Clovis Road, Lubbock, TX 79415 | 2006-05-31 |
| 1891768321 | Community Health Center of Lubbock, Inc | Clinic/Center | 406 Mlk Blvd, Lubbock, TX 79403 | 2006-02-07 |
| 1528030087 | Community Health Center of Lubbock, Inc. | Clinic/Center | 2301 Cedar Ave, Lubbock, TX 79404 | 2006-02-07 |
| 1093269904 | Community Health Clinic Lubbock | Clinic/Center | 1610 5th St, Lubbock, TX 79401-2622 | 2016-08-09 |
| 1407116304 | South Plains Rural Health Services, Inc | Clinic/Center | 2424 50th St, Suite 204, Lubbock, TX 79412-2549 | 2012-05-24 |
| 1609023191 | Texas Tech University Health Sciences Center - Son - Lubbock | Clinic/Center | 301 40th St, Lubbock, TX 79404-2811 | 2008-08-26 |
| Find all providers in LUBBOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.