Provider Demographics
NPI:1790265056
Name:COMMUNITY HEALTH CARE SYSTEMS INC,
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CARE SYSTEMS INC,
Other - Org Name:COMMUNITY HEALTH CARE SYSTEMS, INC-TALIAFERRO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:W
Authorized Official - Last Name:BELCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-552-7384
Mailing Address - Street 1:PO BOX 371
Mailing Address - Street 2:
Mailing Address - City:WRIGHTSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31096-0371
Mailing Address - Country:US
Mailing Address - Phone:478-864-3448
Mailing Address - Fax:478-864-1288
Practice Address - Street 1:557A BROAD ST NW
Practice Address - Street 2:
Practice Address - City:CRAWFORDVILLE
Practice Address - State:GA
Practice Address - Zip Code:30631-2918
Practice Address - Country:US
Practice Address - Phone:478-864-3448
Practice Address - Fax:478-864-1288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)