Healthcare Provider Details

I. General information

NPI: 1720418312
Provider Name (Legal Business Name): COMMUNITY HOSPITAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2013
Last Update Date: 11/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 PROGRESS ST
EDISON NJ
08820-1180
US

IV. Provider business mailing address

65 JAMES ST
EDISON NJ
08820-3947
US

V. Phone/Fax

Practice location:
  • Phone: 908-912-1910
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RICHARD SMITH
Title or Position: CFO
Credential:
Phone: 732-321-7000