Healthcare Provider Details

I. General information

NPI: 1275848772
Provider Name (Legal Business Name): CHS HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2010
Last Update Date: 02/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 DISCOVERY DR
ORLANDO FL
32826-3712
US

IV. Provider business mailing address

5500 MARYLAND WAY STE 400
BRENTWOOD TN
37027-4948
US

V. Phone/Fax

Practice location:
  • Phone: 407-965-3266
  • Fax: 407-282-7640
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. STUART CLARK
Title or Position: EXECUTIVE VP
Credential:
Phone: 615-577-4927