MEDICARE: COMMUNITY HEALTH SERVICES , 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	261QR1300X	Rural Health Clinic/Center	150083	KY
2	251B00000X	Case Management Agency	150083	KY
3	251E00000X	Home Health Agency	150083	KY

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154323327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH SERVICES , INC

Provider Business Mailing Address
First Line	:	726 HARVARD DR
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42301-6152
Country	:	US
Telephone Number	:	270-685-4663
Fax Number	:	270-685-4683

Provider Business Practice Location Address
First Line	:	726 HARVARD DR
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42301-6152
Country	:	US
Telephone Number	:	270-685-4663
Fax Number	:	270-685-4683

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. FARIS SARDAR
Credential	:
Telephone Number	:	859-219-3939

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	09/23/2013

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Directions to “COMMUNITY HEALTH SERVICES , INC ” Practice Location

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