Healthcare Provider Details

I. General information

NPI: 1245400969
Provider Name (Legal Business Name): COMMUNITY HEALTH CARE SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2008
Last Update Date: 03/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 WEST MAIN ST
GIBSON GA
30810-4135
US

IV. Provider business mailing address

PO BOX 371
WRIGHTSVILLE GA
31096-0371
US

V. Phone/Fax

Practice location:
  • Phone: 706-598-3359
  • Fax: 706-598-3403
Mailing address:
  • Phone: 478-864-3448
  • Fax: 478-864-1288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: CARLA W BELCHER
Title or Position: CEO
Credential:
Phone: 478-552-7384