Healthcare Provider Details

I. General information

NPI: 1154323327
Provider Name (Legal Business Name): COMMUNITY HEALTH SERVICES , INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 09/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

726 HARVARD DR
OWENSBORO KY
42301-6152
US

IV. Provider business mailing address

726 HARVARD DR
OWENSBORO KY
42301-6152
US

V. Phone/Fax

Practice location:
  • Phone: 270-685-4663
  • Fax: 270-685-4683
Mailing address:
  • Phone: 270-685-4663
  • Fax: 270-685-4683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number150083
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number150083
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number150083
License Number StateKY

VIII. Authorized Official

Name: MR. FARIS SARDAR
Title or Position: VICE PRESIDENT
Credential:
Phone: 859-219-3939