| Community Health Service Agency Inc | |
|
4500 Wesley St Greenville TX 75401-5644 | |
| (903) 454-3025 | |
| (903) 450-1408 |
| Full Name | Community Health Service Agency Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 4500 Wesley St, Greenville, Texas |
| Authorized Official Name and Position | Michelle Carter (CEO) |
| Authorized Official Contact | 9034555986 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Service Agency Inc Po Box 1908 Greenville TX 75403-1908 Ph: (903) 454-3025 | Community Health Service Agency Inc 4500 Wesley St Greenville TX 75401-5644 Ph: (903) 454-3025 |
| NPI Number | 1922486505 |
|---|---|
| Provider Enumeration Date | 05/14/2015 |
| Last Update Date | 05/14/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922486505 | NPI | - | NPPES |
| 00CN31 | Other | TX | MEDICARE/NOVITAS |
| 081921102 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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