Provider Demographics
NPI:1558553297
Name:COMPLETE PATIENT SERVICES
Entity Type:Organization
Organization Name:COMPLETE PATIENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:G
Authorized Official - Last Name:STOUDENMIRE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:251-460-0300
Mailing Address - Street 1:1104 US HIGHWAY 280 BYPASS
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36867
Mailing Address - Country:US
Mailing Address - Phone:334-664-2241
Mailing Address - Fax:334-664-2242
Practice Address - Street 1:1104 US HIGHWAY 280 BYPASS
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867
Practice Address - Country:US
Practice Address - Phone:334-664-2241
Practice Address - Fax:334-664-2242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL763332B00000X
AL1256332BP3500X
AL9000644332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies