Provider Demographics
NPI:1376849703
Name:COMMUNITY HEALTH AND EMERGENCY SERVICES, INC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH AND EMERGENCY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDRICK
Authorized Official - Middle Name:L
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:618-457-0450
Mailing Address - Street 1:PO BOX 3008
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62902-3008
Mailing Address - Country:US
Mailing Address - Phone:618-457-0450
Mailing Address - Fax:618-457-4329
Practice Address - Street 1:203 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:GALATIA
Practice Address - State:IL
Practice Address - Zip Code:62935-1216
Practice Address - Country:US
Practice Address - Phone:618-268-6108
Practice Address - Fax:618-268-6296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)