Healthcare Provider Details

I. General information

NPI: 1073572350
Provider Name (Legal Business Name): COMMUNITY HEALTH & EMERGENCY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 08/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 CEDAR CT
CARBONDALE IL
62901-5334
US

IV. Provider business mailing address

PO BOX 3008
CARBONDALE IL
62902-3008
US

V. Phone/Fax

Practice location:
  • Phone: 618-351-1213
  • Fax: 618-351-1905
Mailing address:
  • Phone: 618-457-0450
  • Fax: 618-457-7329

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: MR. FREDERICK BERNSTEIN
Title or Position: C.E.O.
Credential:
Phone: 618-457-0450