Provider Demographics
NPI:1144245192
Name:COMMUNITY PHYSICIANS SERVICES CORPORATION
Entity Type:Organization
Organization Name:COMMUNITY PHYSICIANS SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:STURGILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-679-8890
Mailing Address - Street 1:96 15TH ST NW
Mailing Address - Street 2:STE 104
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-1620
Mailing Address - Country:US
Mailing Address - Phone:276-679-8890
Mailing Address - Fax:276-679-9740
Practice Address - Street 1:96 15TH ST NW
Practice Address - Street 2:STE 104
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1620
Practice Address - Country:US
Practice Address - Phone:276-679-8890
Practice Address - Fax:276-679-9740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
C04698OtherMEDICARE GROUP
C03526Medicare ID - Type UnspecifiedGROUP
C03527Medicare ID - Type UnspecifiedGROUP NUMBER