Healthcare Provider Details
I. General information
NPI: 1699203349
Provider Name (Legal Business Name): COMMUNITY FIRST HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/25/2017
Last Update Date: 04/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8595 BEECHMONT AVE STE 200
CINCINNATI OH
45255-4740
US
IV. Provider business mailing address
PO BOX 32113
LOUISVILLE KY
40232-2113
US
V. Phone/Fax
- Phone: 513-713-0177
- Fax: 513-268-7744
- Phone: 513-447-3009
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CURTIS
SHAIN
Title or Position: CEO
Credential:
Phone: 502-420-8062