Healthcare Provider Details

I. General information

NPI: 1538497235
Provider Name (Legal Business Name): COMMUNITY HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2009
Last Update Date: 07/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24747 REDLANDS BLVD SUITE D
LOMA LINDA CA
92354-4026
US

IV. Provider business mailing address

24747 REDLANDS BLVD SUITE D
LOMA LINDA CA
92354-4026
US

V. Phone/Fax

Practice location:
  • Phone: 877-616-6247
  • Fax: 909-796-2830
Mailing address:
  • Phone: 877-616-6247
  • Fax: 909-796-2830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY50129
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPHY50129
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License NumberPHY50129
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code3336M0003X
TaxonomyManaged Care Organization Pharmacy
License NumberPHY50129
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPHY50129
License Number StateCA

VIII. Authorized Official

Name: ALLEN SCORSATTO
Title or Position: PHARMACIST IN CHARGE
Credential: RPH
Phone: 877-616-6247