Provider Demographics
NPI:1467458125
Name:COMPREHENSIVE MEDICAL HOME CARE INC
Entity Type:Organization
Organization Name:COMPREHENSIVE MEDICAL HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PARIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:570-451-3050
Mailing Address - Street 1:716 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AVOCA
Mailing Address - State:PA
Mailing Address - Zip Code:18641-1623
Mailing Address - Country:US
Mailing Address - Phone:570-451-3050
Mailing Address - Fax:570-451-3055
Practice Address - Street 1:716 MAIN ST
Practice Address - Street 2:
Practice Address - City:AVOCA
Practice Address - State:PA
Practice Address - Zip Code:18641-1623
Practice Address - Country:US
Practice Address - Phone:570-451-3050
Practice Address - Fax:570-451-3055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA762605251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015170640002Medicaid
PA0015170640002Medicaid