Healthcare Provider Details

I. General information

NPI: 1073230504
Provider Name (Legal Business Name): COMMUNITY HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 10/25/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

772 BOLT ROAD
FAIRDALE WV
25839
US

IV. Provider business mailing address

252 RURAL ACRES DR
BECKLEY WV
25801-3503
US

V. Phone/Fax

Practice location:
  • Phone: 304-719-8949
  • Fax: 304-934-7835
Mailing address:
  • Phone: 304-252-8324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLES HUNT
Title or Position: CEO
Credential:
Phone: 304-252-8324