Healthcare Provider Details

I. General information

NPI: 1568806297
Provider Name (Legal Business Name): COMMUNITY HEALTH CARE SYSTEMS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 05/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 E WILLOW CREEK LN
MC RAE GA
31055
US

IV. Provider business mailing address

82 PARSONAGE ST
MC RAE GA
31055-4509
US

V. Phone/Fax

Practice location:
  • Phone: 478-864-3448
  • Fax: 478-864-1288
Mailing address:
  • Phone: 229-860-4117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CARLA W BELCHER
Title or Position: CEO
Credential:
Phone: 478-864-3448