1013976919 NPI number — COMMUNITY HEALTH & EMERGENCY SERVICES, INC

Table of content: (NPI 1013976919)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013976919 NPI number — COMMUNITY HEALTH & EMERGENCY SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY HEALTH & EMERGENCY SERVICES, 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:
1013976919
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3008
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARBONDALE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
62902-3008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
618-457-0450
Provider Business Mailing Address Fax Number:
618-457-7329

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62946-1272
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-253-8450
Provider Business Practice Location Address Fax Number:
618-253-8454
Provider Enumeration Date:
03/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BERNSTEIN
Authorized Official First Name:
FREDERICK
Authorized Official Middle Name:
Authorized Official Title or Position:
C.E.O.
Authorized Official Telephone Number:
618-457-0450

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)





Copyright © 2007-2025 www.npivalidator.com