Provider Demographics
NPI: | 1750631099 |
---|---|
Name: | COMMUNITY HEALTH SYSTEMS INC. |
Entity Type: | Organization |
Organization Name: | COMMUNITY HEALTH SYSTEMS INC. |
Other - Org Name: | BECKLEY STATTON SCHOOL-BASED CLINIC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | CHARLES |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HUNT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 304-252-8324 |
Mailing Address - Street 1: | 252 RURAL ACRES DR. |
Mailing Address - Street 2: | |
Mailing Address - City: | BECKLEY |
Mailing Address - State: | WV |
Mailing Address - Zip Code: | 25801 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 304-252-8324 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 401 GREY FLATS RD |
Practice Address - Street 2: | |
Practice Address - City: | BECKLEY |
Practice Address - State: | WV |
Practice Address - Zip Code: | 25801-5876 |
Practice Address - Country: | US |
Practice Address - Phone: | 304-461-3304 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-09-13 |
Last Update Date: | 2014-04-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QF0400X | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) | Group - Multi-Specialty |