Provider Demographics
NPI:1154323327
Name:COMMUNITY HEALTH SERVICES , INC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH SERVICES , INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SARDAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-219-3939
Mailing Address - Street 1:726 HARVARD DR
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-6152
Mailing Address - Country:US
Mailing Address - Phone:270-685-4663
Mailing Address - Fax:270-685-4683
Practice Address - Street 1:726 HARVARD DR
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-6152
Practice Address - Country:US
Practice Address - Phone:270-685-4663
Practice Address - Fax:270-685-4683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY150083251B00000X, 251E00000X, 261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100201330Medicaid
KY7100168450Medicaid
KY34002303Medicaid
KY34002303Medicaid