Healthcare Provider Details

I. General information

NPI: 1790153997
Provider Name (Legal Business Name): COMMUNITY HEALTH CARE SYSTEMS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2015
Last Update Date: 10/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102A AIRPORT ROAD NE
MILLEDGEVILLE GA
31061-9313
US

IV. Provider business mailing address

2251 W ELM ST P O BOX 371
WRIGHTSVILLE GA
31096-2017
US

V. Phone/Fax

Practice location:
  • Phone: 478-864-3448
  • Fax: 478-864-1288
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 StateGA

VIII. Authorized Official

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