# CHIEFLAND HEALTH CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114549284
- **Authorized official:** ASHWIN KOLAVENTY (MANAGER)
- **Authorized official phone:** (352) 507-2000

## Contact information

- **Practice address:** 304 N MAIN ST, CHIEFLAND, FL 32626-0803
- **Practice address phone:** (352) 507-2000
- **Mailing address:** 304 N MAIN ST, CHIEFLAND, FL 32626-0803
- **Mailing address phone:** (352) 507-2000
- **Mailing address fax:** (352) 644-4544

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 208800000X | Urology Physician | — | — | — |
| 261QP2300X | Primary Care Clinic/Center | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 05/12/2020
- **Last updated:** 09/09/2026