MEDICARE: COMMUNITY HEALTH SYSTEMS, 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 Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4492234	OTHER	AETNA
3	070480400	OTHER	FEDERAL BLACK LUNG
4	001709417	OTHER	BLUECROSS BLUESHIELD

General Provider Information

NPI Number	:	1194897082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH SYSTEMS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 147
Second Line	:
City	:	DOROTHY
State	:	WV
Zip	:	25060-0147
Country	:	US
Telephone Number	:	304-854-1324
Fax Number	:	304-854-1996

Provider Business Practice Location Address
First Line	:	HOME SCHOOL VILLAGE #1
Second Line	:
City	:	COLCORD
State	:	WV
Zip	:	25048
Country	:	US
Telephone Number	:	304-854-1324
Fax Number	:	304-854-1996

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	CHARLES HUNT
Credential	:
Telephone Number	:	304-252-8551

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	05/30/2008

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Directions to “COMMUNITY HEALTH SYSTEMS, INC. ” Practice Location

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