Healthcare Provider Details

I. General information

NPI: 1164809828
Provider Name (Legal Business Name): COMMUNITY HEALTH CARE SYSTEMS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2015
Last Update Date: 08/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2562 E ELM ST
WRIGHTSVILLE GA
31096
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 Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

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