Provider Demographics
NPI:1588833115
Name:COMMUNITY HEALTH SYSTEMS INC
Entity type:Organization
Organization Name:COMMUNITY HEALTH SYSTEMS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTCHER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:304-255-8551
Mailing Address - Street 1:252 RURAL ACRES DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3503
Mailing Address - Country:US
Mailing Address - Phone:304-255-6800
Mailing Address - Fax:304-256-6258
Practice Address - Street 1:ONE PHYSICIANS DRIVE
Practice Address - Street 2:
Practice Address - City:LOCHGELLY
Practice Address - State:WV
Practice Address - Zip Code:25866
Practice Address - Country:US
Practice Address - Phone:304-461-0068
Practice Address - Fax:304-461-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0002X, 3336C0004X
WVSP05523723336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810013656Medicaid
2111735OtherPK