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General NPI Number Information
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NPI Number | 1598937740
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE MEDICAL CARE SERVICES,INC.
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 2295 TOWNE LAKE PKWY SUITE 116-188
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City | WOODSTOCK
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State | GA
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Zip | 30189-5520
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Country | US
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Telephone | 404-754-5353
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Fax | 888-920-0049
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Provider Business Mailing Address
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Address Line | 2870 PEACHTREE RD NW # 884
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City | ATLANTA
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State | GA
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Zip | 30305-2918
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Country | US
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Telephone | 404-754-5353
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Fax | 888-920-0049
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JUAN CARRALERO
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Credential |
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Telephone | 404-754-5353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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