Basic Information
| Provider Information | |||||||||
| NPI: | 1215684063 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNITY HEALTH SYSTEMS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21801 ALESSANDRO BLVD | ||||||||
| Address2: | |||||||||
| City: | MORENO VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925538202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9515712300 | ||||||||
| FaxNumber: | 9513790482 | ||||||||
| Practice Location | |||||||||
| Address1: | 18651 VALLEY BLVD UNIT C | ||||||||
| Address2: | |||||||||
| City: | BLOOMINGTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923161831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095467520 | ||||||||
| FaxNumber: | 9098775468 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2022 | ||||||||
| LastUpdateDate: | 08/19/2022 | ||||||||
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| AuthorizedOfficialLastName: | ORTIZ | ||||||||
| AuthorizedOfficialFirstName: | VANESSA | ||||||||
| AuthorizedOfficialMiddleName: | IVONNE | ||||||||
| AuthorizedOfficialTitleorPosition: | SR. EXECUTIVE ASSISTANT | ||||||||
| AuthorizedOfficialTelephone: | 9515712300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336C0003X | Y | Suppliers | Pharmacy | Community/Retail Pharmacy |
No ID Information.