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General NPI Number Information
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NPI Number | 1932632858
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1549 OLD BRIDGE RD
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City | WOODBRIDGE
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State | VA
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Zip | 22192-2737
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Country | US
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Telephone | 703-490-8200
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Fax | 703-490-8225
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Provider Business Mailing Address
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Address Line | 1549 OLD BRIDGE RD
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City | WOODBRIDGE
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State | VA
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Zip | 22192-2737
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Country | US
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Telephone | 703-490-8200
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Fax | 703-490-8225
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Authorized Official
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Title or Position | PA, DIRECTOR
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Name | TANYA BELLIARD
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Credential |
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Telephone | 703-490-8200
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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 | 0101230929
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0110002382
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License Number State | VA
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