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NPI Code Detail

MEDICARE: COMMUNITY HEALTH & EMERGENCY SERVICES, INC.

MEDICARE: COMMUNITY HEALTH & EMERGENCY 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
1261QF0400XFederally Qualified Health Center (FQHC)

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CI2819OTHERILRRMEDICARE/PALMETTO GBA
2CB1159OTHERILRRMEDICARE/PALMETTO GBA
3CA5418OTHERILRRMEDICARE/PALMETTO GBA

General Provider Information

NPI Number : 1710979588
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY HEALTH & EMERGENCY SERVICES, INC.
Provider Business Mailing Address
First Line : PO BOX 3008
Second Line :
City : CARBONDALE
State : IL
Zip : 62902-3008
Country : US
Telephone Number : 618-457-0450
Fax Number : 618-457-7329
Provider Business Practice Location Address
First Line : 13245 KESSLER RD
Second Line :
City : CAIRO
State : IL
Zip : 62914
Country : US
Telephone Number : 618-734-4400
Fax Number :
Authorized Official
Title or Position : CEO
Name : MR. FREDERICK L BERNSTEIN
Credential :
Telephone Number : 618-457-0450
Provider Enumeration Date : 08/18/2005
Last Update Date : 08/22/2018

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