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General NPI Number Information
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NPI Number | 1982673836
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE CARE LLC
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 1911 HAMPTON ST
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City | COLUMBIA
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State | SC
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Zip | 29201-3535
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Country | US
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Telephone | 803-256-1511
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Fax | 803-256-7333
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Provider Business Mailing Address
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Address Line | PO BOX 2246
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City | COLUMBIA
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State | SC
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Zip | 29202-2246
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Country | US
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Telephone | 803-256-1511
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Fax | 803-256-7333
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Authorized Official
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Title or Position | CO OWNER
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Name | MR. ROBERT B BORUCKI
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Credential | MD
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Telephone | 803-236-1511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | SC
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