MEDICARE: COMMUNITY HEALTH CENTERS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1063037232
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH CENTERS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 30589
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73140-3589
Country	:	US
Telephone Number	:	405-769-3301
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 NW 11TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73103-3913
Country	:	US
Telephone Number	:	405-272-0476
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ISABELLA LAWSON
Credential	:	MA
Telephone Number	:	405-769-3301

Provider Enumeration Date	:	06/12/2020
Last Update Date	:	06/12/2020

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