Provider Demographics
NPI:1073881256
Name:COMPRE CARE MEDICAL
Entity Type:Organization
Organization Name:COMPRE CARE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTSHELER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:314-739-3990
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-474-9809
Mailing Address - Fax:
Practice Address - Street 1:3440 DE PAUL LN
Practice Address - Street 2:SUITE 110
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-3545
Practice Address - Country:US
Practice Address - Phone:314-739-3990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPRE CARE MEDICAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-02
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site