MEDICARE: CHAPEL HILL MEDICAL SERVICES LLC

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	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1063914349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAPEL HILL MEDICAL SERVICES LLC

Provider Business Mailing Address
First Line	:	4308 MILLER AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-2628
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4308 MILLER AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-2628
Country	:	US
Telephone Number	:	866-918-3332
Fax Number	:	561-584-7284

Authorized Official
Title or Position	:	REPRESENTATIVE
Name	:	JOHN NASH
Credential	:
Telephone Number	:	866-918-3332

Provider Enumeration Date	:	03/02/2018
Last Update Date	:	02/04/2020

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