MEDICARE: CHS HEALTH 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
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1861811168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHS HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	5500 MARYLAND WAY STE 200
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-4973
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 W LASKEY RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43612-2909
Country	:	US
Telephone Number	:	419-470-0711
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE VP
Name	:	STUART CLARK
Credential	:
Telephone Number	:	615-577-4927

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	08/18/2016

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Directions to “CHS HEALTH SERVICES, INC ” Practice Location

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