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)

General Provider Information

NPI Number	:	1699030528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH CENTERS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 30589
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73140
Country	:	US
Telephone Number	:	405-769-3301
Fax Number	:	405-769-9685

Provider Business Practice Location Address
First Line	:	105 E. SANTA FE
Second Line	:
City	:	CARNEY
State	:	OK
Zip	:	74832
Country	:	US
Telephone Number	:	405-865-2020
Fax Number	:	405-769-9685

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	ISABELLA LAWSON
Credential	:	MBA
Telephone Number	:	405-769-3301

Provider Enumeration Date	:	07/06/2012
Last Update Date	:	03/01/2018

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