Provider Demographics
NPI:1316008345
Name:COMPLETE HEALTH DIAGNOSTICS, INC.
Entity Type:Organization
Organization Name:COMPLETE HEALTH DIAGNOSTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-777-1868
Mailing Address - Street 1:2001 WESTSIDE PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-4994
Mailing Address - Country:US
Mailing Address - Phone:770-777-1868
Mailing Address - Fax:770-777-1872
Practice Address - Street 1:1019 PHYSICIANS DR
Practice Address - Street 2:SUITE B
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5746
Practice Address - Country:US
Practice Address - Phone:843-763-2515
Practice Address - Fax:770-770-1872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ342160003Medicare PIN