Provider Demographics
NPI:1083926760
Name:SAMSERVE CORPORATION
Entity Type:Organization
Organization Name:SAMSERVE CORPORATION
Other - Org Name:COMFORCARE NORTH COUNTY SAN DIEGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:E
Authorized Official - Last Name:SAMUELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-724-7273
Mailing Address - Street 1:830 E VISTA WAY STE 108
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-5216
Mailing Address - Country:US
Mailing Address - Phone:760-724-7273
Mailing Address - Fax:
Practice Address - Street 1:830 E VISTA WAY STE 108
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-5216
Practice Address - Country:US
Practice Address - Phone:760-724-7273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care