Provider Demographics
NPI:1063637643
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:19133-4039
Mailing Address - Country:US
Mailing Address - Phone:215-203-3000
Mailing Address - Fax:215-203-3089
Practice Address - Street 1:2055 E ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-3832
Practice Address - Country:US
Practice Address - Phone:215-427-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000004060140Medicaid
PA1000004060075Medicaid
PA1000004060135Medicaid
PA1000004060139Medicaid
PA1000004060134Medicaid
PA1000004060141Medicaid