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)
2	333600000X	Pharmacy

General Provider Information

NPI Number	:	1932084159
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	:	220 W 7200 S STE A
Second Line	:
City	:	MIDVALE
State	:	UT
Zip	:	84047-1053
Country	:	US
Telephone Number	:	801-566-5494
Fax Number	:	877-497-4661

Authorized Official
Title or Position	:	CEO
Name	:	JENNIFER THOMAS
Credential	:
Telephone Number	:	801-891-4094

Provider Enumeration Date	:	08/07/2025
Last Update Date	:	08/07/2025

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