MEDICARE: COMMUNITY HEALTH CENTER OF WEST PALM BEACH, 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	261QC1500X	Community Health Clinic/Center	5130	FL

General Provider Information

NPI Number	:	1285899682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH CENTER OF WEST PALM BEACH, INC

Provider Business Mailing Address
First Line	:	2100 WEST 45TH STREET
Second Line	:	SUITE A-8 & A-9
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2063
Country	:	US
Telephone Number	:	561-840-8681
Fax Number	:	561-844-0764

Provider Business Practice Location Address
First Line	:	2100 WEST 45TH STREET
Second Line	:	SUITE A-8 & A-9
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2063
Country	:	US
Telephone Number	:	561-840-8681
Fax Number	:	561-844-0764

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR/PRESIDENT
Name	:	MR. GEORGE J PAPADIMITRIAL
Credential	:
Telephone Number	:	561-840-8681

Provider Enumeration Date	:	07/24/2008
Last Update Date	:	01/04/2017

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