=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275650301
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMPREHENSIVE MEDICAL SOLUTIONS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5595 CAROLINA WAY
-----------------------------------------------------
City | BURLINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41005-9167
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-653-0245
-----------------------------------------------------
Fax | 859-356-9027
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5595 CAROLINA WAY
-----------------------------------------------------
City | BURLINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41005-9167
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-653-0245
-----------------------------------------------------
Fax | 859-356-9027
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. DJ THOMAS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 859-653-0245
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 303142
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------