MEDICARE: COMPREHENSIVE HEALTHCARE SOLUTIONS 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	171W00000X	Contractor

General Provider Information

NPI Number	:	1801323688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE HEALTHCARE SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	PO BOX 436611
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40253-6611
Country	:	US
Telephone Number	:	502-303-0919
Fax Number	:

Provider Business Practice Location Address
First Line	:	12409 WYNMEADE PL
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-1630
Country	:	US
Telephone Number	:	502-303-0919
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KRISTEN BRANNON
Credential	:	BILLING AGENT
Telephone Number	:	502-303-0919

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	05/11/2017

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