Provider Demographics
NPI:1013043702
Name:COMHAR, INC
Entity Type:Organization
Organization Name:COMHAR, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:ELAVUMKAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-203-3000
Mailing Address - Street 1:100 W LEHIGH AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19133-4097
Mailing Address - Country:US
Mailing Address - Phone:215-203-3000
Mailing Address - Fax:215-203-3089
Practice Address - Street 1:100 W LEHIGH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-4097
Practice Address - Country:US
Practice Address - Phone:215-203-3000
Practice Address - Fax:215-203-3089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA479723Medicare ID - Type UnspecifiedMEDICARE