1245400969 NPI number — COMMUNITY HEALTH CARE SYSTEMS, INC.

Table of content: DR. MARY ELIZABETH BONAFEDE M.D. (NPI 1376627661)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245400969 NPI number — COMMUNITY HEALTH CARE SYSTEMS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY HEALTH CARE SYSTEMS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245400969
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 371
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WRIGHTSVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31096-0371
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
478-864-3448
Provider Business Mailing Address Fax Number:
478-864-1288

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
702 WEST MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GIBSON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30810-4135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-598-3359
Provider Business Practice Location Address Fax Number:
706-598-3403
Provider Enumeration Date:
03/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
BELCHER
Authorized Official First Name:
CARLA
Authorized Official Middle Name:
W
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
478-552-7384

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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