Provider Demographics
NPI:1134288764
Name:COMMUNITY HOSPITAL INC
Entity Type:Organization
Organization Name:COMMUNITY HOSPITAL INC
Other - Org Name:COMMUNITY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-283-3734
Mailing Address - Street 1:805 FRIENDSHIP RD
Mailing Address - Street 2:
Mailing Address - City:TALLASSEE
Mailing Address - State:AL
Mailing Address - Zip Code:36078-1234
Mailing Address - Country:US
Mailing Address - Phone:334-283-3734
Mailing Address - Fax:334-283-3758
Practice Address - Street 1:1526 GILMER AVE
Practice Address - Street 2:
Practice Address - City:TALLASSEE
Practice Address - State:AL
Practice Address - Zip Code:36078-2336
Practice Address - Country:US
Practice Address - Phone:334-283-3734
Practice Address - Fax:334-283-3758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL004268251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALCOM7135AMedicaid
AL017135Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER