Healthcare Provider Details

I. General information

NPI: 1093226243
Provider Name (Legal Business Name): COMMUNITY HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2017
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18651 VALLEY BLVD UNIT A
BLOOMINGTON CA
92316-1831
US

IV. Provider business mailing address

7880 MISSION GROVE PKWY S
RIVERSIDE CA
92508-6000
US

V. Phone/Fax

Practice location:
  • Phone: 951-571-2300
  • Fax:
Mailing address:
  • Phone: 951-571-2300
  • Fax: 951-200-3063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: LORI HOLEMAN
Title or Position: CEO
Credential:
Phone: 951-571-2300