Healthcare Provider Details

I. General information

NPI: 1548465362
Provider Name (Legal Business Name): COMPLIMENTARY HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8355 LORETTO AVE
PHILADELPHIA PA
19152-1830
US

IV. Provider business mailing address

107 NAUDAIN ST
PHILADELPHIA PA
19147-2406
US

V. Phone/Fax

Practice location:
  • Phone: 215-742-7033
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: DR. HENRY SHEPHARD
Title or Position: DIRECTOR
Credential:
Phone: 215-545-1785