Provider Demographics
NPI:1578962882
Name:COMPREHENSIVE PAIN SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:COMPREHENSIVE PAIN SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-249-1922
Mailing Address - Street 1:4450 FASHION SQUARE BLVD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-1251
Mailing Address - Country:US
Mailing Address - Phone:989-249-1922
Mailing Address - Fax:989-249-0227
Practice Address - Street 1:5154 MILLER RD
Practice Address - Street 2:UNITS 3 & 4
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1065
Practice Address - Country:US
Practice Address - Phone:989-249-1922
Practice Address - Fax:989-249-0227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23D2080211291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI23D2080211OtherCLIA ID NUMBER
MIMI7578Medicare UPIN