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1245415389

NPI Code Detail

MEDICARE: COMPREHENSIVE FAMILY HEALTH CARE LLC

MEDICARE: COMPREHENSIVE FAMILY HEALTH CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	100630	MO
2	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	221260	OTHER	MO	BCBS
3	175986	OTHER		HEALTHLINK

General Provider Information

NPI Number	:	1245415389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE FAMILY HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 1396
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63702-1396
Country	:	US
Telephone Number	:	573-335-1344
Fax Number	:	573-335-3992

Provider Business Practice Location Address
First Line	:	142 S WINCHESTER ST
Second Line	:
City	:	BENTON
State	:	MO
Zip	:	63736-0000
Country	:	US
Telephone Number	:	573-335-1344
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. ROBIN E. MILLER
Credential	:
Telephone Number	:	573-561-4814

Provider Enumeration Date	:	01/08/2008
Last Update Date	:	08/22/2017

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Directions to “COMPREHENSIVE FAMILY HEALTH CARE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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