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General NPI Number Information
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NPI Number | 1174890081
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE HEALTHCARE MANAGEMENT
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Dates
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Enumeration Date | 11/20/2011
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Last Update Date | 11/20/2011
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Provider Practice Location Address
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Address Line | 505 GLEN IVY
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City | MARIETTA
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State | GA
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Zip | 30062-9405
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Country | US
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Telephone | 404-422-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 505 GLEN IVY
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City | MARIETTA
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State | GA
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Zip | 30062-9405
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. FARRIS D GRANSBERRY JR.
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Credential | PHARM. D
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Telephone | 404-422-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | RPH021895
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | RPH021895
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 3336M0003X
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Taxonomy Name | Managed Care Organization Pharmacy
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License Number | RPH021895
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License Number State | GA
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