Healthcare Provider Details

I. General information

NPI: 1073506465
Provider Name (Legal Business Name): COMMUNITY HEALTH SYSTEMS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5493 MAPLE LN
FAYETTEVILLE WV
25840-6872
US

IV. Provider business mailing address

252 RURAL ACRES DR.
BECKLEY WV
25801
US

V. Phone/Fax

Practice location:
  • Phone: 304-469-3334
  • Fax: 304-465-1735
Mailing address:
  • Phone: 304-252-8324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateWV

VIII. Authorized Official

Name: MR. CHARLES HUNT I
Title or Position: CEO
Credential:
Phone: 304-252-2324