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General NPI Number Information
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NPI Number | 1720059389
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTHCARE SYSTEM, INC
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | 1603 W 4TH ST
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City | HOLTON
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State | KS
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Zip | 66436-1153
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Country | US
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Telephone | 785-364-3205
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Fax | 785-364-3468
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Provider Business Mailing Address
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Address Line | 1603 W 4TH ST
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City | HOLTON
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State | KS
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Zip | 66436-1153
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Country | US
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Telephone | 785-364-3205
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Fax | 785-364-3468
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Authorized Official
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Title or Position | CEO
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Name | MR. TODD M WILLERT
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Credential |
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Telephone | 785-889-5002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | H075001
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License Number State | KS
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