Healthcare Provider Details

I. General information

NPI: 1114109683
Provider Name (Legal Business Name): COMMUNITY HEALTH SYSTEMS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 05/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CARRIAGE DR
BECKLEY WV
25801-2876
US

IV. Provider business mailing address

252 RURAL ACRES DR
BECKLEY WV
25801-3503
US

V. Phone/Fax

Practice location:
  • Phone: 304-252-0609
  • Fax: 304-252-0646
Mailing address:
  • Phone: 304-253-2628
  • Fax: 304-252-1790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES HUNT
Title or Position: EXUCTIVE DIRECTOR
Credential:
Phone: 304-252-8324