MEDICARE: COMMUNITY HEALTH CENTERS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083011639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH CENTERS, INC

Provider Business Mailing Address
First Line	:	110 S WOODLAND ST
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-3546
Country	:	US
Telephone Number	:	407-905-8827
Fax Number	:	407-905-8998

Provider Business Practice Location Address
First Line	:	7912 FOREST CITY RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32810-2907
Country	:	US
Telephone Number	:	407-905-8827
Fax Number	:	407-905-8998

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MARGARET BRENNAN
Credential	:
Telephone Number	:	407-905-8827

Provider Enumeration Date	:	11/25/2014
Last Update Date	:	02/05/2018

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