Provider Demographics
NPI:1285899682
Name:COMMUNITY HEALTH CENTER OF WEST PALM BEACH, INC
Entity type:Organization
Organization Name:COMMUNITY HEALTH CENTER OF WEST PALM BEACH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAPADIMITRIAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-840-8681
Mailing Address - Street 1:2100 WEST 45TH STREET
Mailing Address - Street 2:SUITE A-8 & A-9
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2063
Mailing Address - Country:US
Mailing Address - Phone:561-840-8681
Mailing Address - Fax:561-844-0764
Practice Address - Street 1:2100 WEST 45TH STREET
Practice Address - Street 2:SUITE A-8 & A-9
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2063
Practice Address - Country:US
Practice Address - Phone:561-840-8681
Practice Address - Fax:561-844-0764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-24
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5130261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health