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NPI Code Detail

MEDICARE: COMMUNITY HEALTH CENTERS, INC.

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
1122300000XDentist
2207Q00000XFamily Medicine Physician
3207V00000XObstetrics & Gynecology Physician
4208000000XPediatrics Physician
5261QM1300XMulti-Specialty Clinic/Center
6363A00000XPhysician Assistant
7363L00000XNurse Practitioner
8261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1538267828
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY HEALTH CENTERS, INC.
Provider Business Mailing Address
First Line : 1455 W 2200 S STE 300
Second Line :
City : WEST VALLEY CITY
State : UT
Zip : 84119-7219
Country : US
Telephone Number : 801-412-6920
Fax Number : 877-497-4661
Provider Business Practice Location Address
First Line : 1365 W 1000 N
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84116-1654
Country : US
Telephone Number : 801-328-5750
Fax Number : 801-521-7463
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : JENNIFER LYN THOMAS
Credential :
Telephone Number : 801-412-6920
Provider Enumeration Date : 09/20/2006
Last Update Date : 10/30/2023

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

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