Provider Demographics
NPI:1174861611
Name:COMPLETE CARE CENTER INC
Entity Type:Organization
Organization Name:COMPLETE CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:HURST
Authorized Official - Last Name:PEACOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:334-501-8867
Mailing Address - Street 1:1685 E UNIVERSITY DR STE E
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-5217
Mailing Address - Country:US
Mailing Address - Phone:334-501-8867
Mailing Address - Fax:866-929-4872
Practice Address - Street 1:1685 E UNIVERSITY DR STE E
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5217
Practice Address - Country:US
Practice Address - Phone:334-501-8867
Practice Address - Fax:866-929-4872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL2129111NR0400X
AL1-092190208100000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty