MEDICARE: CHRISTIAN COMMUNITY HEALTH SERVICES

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	207Q00000X	Family Medicine Physician
2	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1811446834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTIAN COMMUNITY HEALTH SERVICES

Provider Business Mailing Address
First Line	:	5 E LIBERTY ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-8202
Country	:	US
Telephone Number	:	513-707-5755
Fax Number	:	513-381-2256

Provider Business Practice Location Address
First Line	:	270 SOUTHERN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-3023
Country	:	US
Telephone Number	:	513-363-5624
Fax Number	:	513-363-5622

Authorized Official
Title or Position	:	CEO
Name	:	MR. JAMES J BERRENS
Credential	:	CPA
Telephone Number	:	513-381-2247

Provider Enumeration Date	:	10/03/2016
Last Update Date	:	02/10/2025

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Directions to “CHRISTIAN COMMUNITY HEALTH SERVICES ” Practice Location

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