Healthcare Provider Details

I. General information

NPI: 1033471412
Provider Name (Legal Business Name): COMMUNITY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2012
Last Update Date: 01/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 ALDEN ST
MEADVILLE PA
16335-2348
US

IV. Provider business mailing address

640 ALDEN ST
MEADVILLE PA
16335-2348
US

V. Phone/Fax

Practice location:
  • Phone: 814-373-5200
  • Fax: 814-373-5205
Mailing address:
  • Phone: 814-373-5200
  • Fax: 814-373-5205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL C. DOWNING
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 814-373-2449