Provider Demographics
NPI:1942720214
Name:COMMUNITY HEALTH PROGRAMS, INC.
Entity Type:Organization
Organization Name:COMMUNITY HEALTH PROGRAMS, INC.
Other - Org Name:CHP BERKSHIRE PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF HUMAN RESOURCES AND COMPLIAN
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-528-9311
Mailing Address - Street 1:P.O. BOX 30
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230
Mailing Address - Country:US
Mailing Address - Phone:413-528-9311
Mailing Address - Fax:413-644-0274
Practice Address - Street 1:CHP BERKSHIRE PEDIATRICS
Practice Address - Street 2:777 NORTH STREET. SUITE 305
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:10201
Practice Address - Country:US
Practice Address - Phone:413-499-8531
Practice Address - Fax:413-499-8560
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HEALTH PROGRAMS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-27
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty