Provider Demographics
NPI:1932632858
Name:COMMUNITY HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:COMMUNITY HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA, DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLIARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-490-8200
Mailing Address - Street 1:1549 OLD BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2737
Mailing Address - Country:US
Mailing Address - Phone:703-490-8200
Mailing Address - Fax:703-490-8225
Practice Address - Street 1:1549 OLD BRIDGE RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2737
Practice Address - Country:US
Practice Address - Phone:703-490-8200
Practice Address - Fax:703-490-8225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110002382207Q00000X
VA0101230929207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty