Provider Demographics
NPI:1386670453
Name:COMMUNITY ACTION MEDICAL SERVICES
Entity Type:Organization
Organization Name:COMMUNITY ACTION MEDICAL SERVICES
Other - Org Name:COMMUNITY MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:RAYMER
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-439-1628
Mailing Address - Street 1:140 N BEESON AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-2937
Mailing Address - Country:US
Mailing Address - Phone:724-439-1628
Mailing Address - Fax:724-439-0171
Practice Address - Street 1:140 N BEESON AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401
Practice Address - Country:US
Practice Address - Phone:724-439-1628
Practice Address - Fax:724-439-0171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)