COMMUNITY HEALTH CENTER OF PINELLAS INC

Provider Demographics

• NPI: 1518998731
• Name: COMMUNITY HEALTH CENTER OF PINELLAS INC
• Entity Type: Organization
• Organization Name: COMMUNITY HEALTH CENTER OF PINELLAS INC
• Authorized Official - Title/Position: CEO
• Authorized Official - First Name: ELODIE
• Authorized Official - Last Name: DORSO
• Authorized Official - Phone: 727-824-8100
• Mailing Address - Street 1: PO BOX 10549
• Mailing Address - City: ST PETERSBURG
• Mailing Address - State: FL
• Mailing Address - Zip Code: 33733-0549
• Mailing Address - Country: US
• Mailing Address - Phone: 727-824-8126
• Mailing Address - Fax: 727-824-8166
• Practice Address - Street 1: 1344 22ND ST S
• Practice Address - City: ST PETERSBURG
• Practice Address - State: FL
• Practice Address - Zip Code: 33712-2744
• Practice Address - Country: US
• Practice Address - Phone: 727-824-8126
• Practice Address - Fax: 727-824-8166
• EIN: <UNAVAIL>
• Is Organization Subpart?: Yes
• Parent Organization LBN: COMMUNITY HEALTH CENTER OF PINELLAS INC
• Parent Organization TIN: <UNAVAIL>
• Enumeration Date: 2006-07-05
• Last Update Date: 2019-12-11

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	261QF0400X	Ambulatory Health Care Facilities	Clinic/Center	Federally Qualified Health Center (FQHC)

Provider Identifiers

State	Identifier ID	ID Type	Issuer
FL	060638301	Medicaid
FL	060638309	Medicaid
FL	029565513	Medicaid
FL	029565522	Medicaid
FL	029565503	Medicaid
FL	029565514	Medicaid
FL	029565517	Medicaid
FL	029565519	Medicaid
FL	029565521	Medicaid
FL	029565501	Medicaid
FL	029565512	Medicaid
FL	029565500	Medicaid
FL	029565516	Medicaid
FL	060638300	Medicaid
FL	060638303	Medicaid
FL	029565515	Medicaid
FL	060638308	Medicaid
FL	029565515	Medicaid
FL	029565516	Medicaid
FL	101983	Medicare Oscar/Certification
FL	101926	Medicare Oscar/Certification
	98798	Medicare PIN
FL	029565519	Medicaid
FL	029565503	Medicaid
FL	029565514	Medicaid
FL	101119	Medicare Oscar/Certification