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General NPI Number Information
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NPI Number | 1346700093
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH RESOURCES, INC.
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 05/15/2019
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Provider Practice Location Address
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Address Line | 153 HAZARD AVE
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City | ENFIELD
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State | CT
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Zip | 06082-4592
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Country | US
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Telephone | 860-253-5020
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Fax | 860-253-5030
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Provider Business Mailing Address
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Address Line | 2 WATERSIDE XING STE 401
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City | WINDSOR
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State | CT
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Zip | 06095-1587
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Country | US
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Telephone | 860-697-3364
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Fax | 860-731-5536
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Authorized Official
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Title or Position | ADMINISTRATIVE SERVICES MANAGER
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Name | KIM KENNEDY
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Credential |
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Telephone | 860-697-3364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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