COMMUNITY HEALTH CENTER OF RICHMOND INC NPI 1114137403

NPI Information

NPI: 1114137403
Provider Name: COMMUNITY HEALTH CENTER OF RICHMOND, INC

Former Legal Business Name: RICHMOND COMMUNITY SUPPORT ORGANIZATION

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
235 PORT RICHMOND AVENUE
STATEN ISLAND, NY
ZIP 10302
Phone: (718) 876-1732
Get Directions

COMMUNITY HEALTH CENTER OF RICHMOND, INC is a federally qualified health center (fqhc) clinic center in Staten Island, NY. COMMUNITY HEALTH CENTER OF RICHMOND, INC NPI is 1114137403. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Richmond Community Support Organization.

The provider's business location address is:

235 PORT RICHMOND AVENUE
STATEN ISLAND, NY
ZIP 10302-701
Phone: (718) 876-1732
Fax: (718) 442-0189

The provider's authorized official is Lucie Gabriel .
The authorized official title is Director Of Patient Financial Servi and has the following contact phone number (718) 924-2254.

The enumeration date for this NPI number is 5/23/2007 and was last updated on 9/24/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	7004210R	NEW YORK	No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	2903588	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A100001122	MEDICARE PIN	NEW YORK
2	33-1988	MEDICARE UPIN	NEW YORK
3	331988	MEDICARE OSCAR/CERTIFICATION	NEW YORK
4	7004210R	OTHER	NEW YORK	OPERATING CERTIFICATE #
5	2903588	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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