Provider Demographics
NPI:1821868803
Name:COMMUNITY HEALTH CENTERS OF PINELLAS INC.
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CENTERS OF PINELLAS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF REGULATORY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KUCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-824-8100
Mailing Address - Street 1:9064 NW 13TH TER
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2907
Mailing Address - Country:US
Mailing Address - Phone:305-392-8084
Mailing Address - Fax:
Practice Address - Street 1:1260 S MARTIN LUTHER KING JR AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-4172
Practice Address - Country:US
Practice Address - Phone:727-824-8181
Practice Address - Fax:727-286-6224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy