Provider Demographics
NPI:1366612277
Name:COMMUNITY HEALTH CENTER, INC
Entity type:Organization
Organization Name:COMMUNITY HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-691-3300
Mailing Address - Street 1:PO BOX 597
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-0433
Mailing Address - Country:US
Mailing Address - Phone:856-691-3300
Mailing Address - Fax:856-794-7183
Practice Address - Street 1:8879 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:PORT NORRIS
Practice Address - State:NJ
Practice Address - Zip Code:08349-3420
Practice Address - Country:US
Practice Address - Phone:856-691-3300
Practice Address - Fax:856-794-7183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty