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NPI Code Detail

MEDICARE: COMMUNITY HEALTH CENTER OF RICHMOND INC

MEDICARE: COMMUNITY HEALTH CENTER OF RICHMOND 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)

General Provider Information

NPI Number : 1952739054
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY HEALTH CENTER OF RICHMOND INC
Provider Business Mailing Address
First Line : 235 PORT RICHMOND AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10302-1701
Country : US
Telephone Number : 718-924-2254
Fax Number : 718-442-0189
Provider Business Practice Location Address
First Line : 439 PORT RICHMOND AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10302-1714
Country : US
Telephone Number : 718-924-2254
Fax Number :
Authorized Official
Title or Position : CEO
Name : HENRY THOMPSON
Credential : FACHE
Telephone Number : 718-924-2254
Provider Enumeration Date : 10/29/2013
Last Update Date : 10/29/2013

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Directions to “COMMUNITY HEALTH CENTER OF RICHMOND INC ” Practice Location

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