MEDICARE: COMSERV, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	315P00000X	Intellectual Disabilities Intermediate Care Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821121757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMSERV, INC.

Provider Business Mailing Address
First Line	:	619 PENNTON AVE SW
Second Line	:
City	:	LENOIR
State	:	NC
Zip	:	28645-5743
Country	:	US
Telephone Number	:	828-757-0209
Fax Number	:

Provider Business Practice Location Address
First Line	:	3252 PLAYMORE BEACH RD
Second Line	:
City	:	MORGANTON
State	:	NC
Zip	:	28655
Country	:	US
Telephone Number	:	828-754-1300
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DAWN KELLEY
Credential	:
Telephone Number	:	828-325-4926

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	07/16/2018

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Directions to “COMSERV, INC. ” Practice Location

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