1356992275 NPI number — COMMUNITY HEALTH CARE SYSTEMS, INC

Table of content: MRS. PATRICE ROZELL WILLS MS, LPC (NPI 1790093581)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356992275 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:
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:
1356992275
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/23/2019
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:
100 N ABC STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILLEDGEVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
478-215-4009
Provider Business Practice Location Address Fax Number:
478-864-1288
Provider Enumeration Date:
09/23/2019

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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