Provider Demographics
NPI:1598937740
Name:COMPREHENSIVE MEDICAL CARE SERVICES,INC.
Entity Type:Organization
Organization Name:COMPREHENSIVE MEDICAL CARE SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRALERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-754-5353
Mailing Address - Street 1:2870 PEACHTREE RD NW # 884
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2918
Mailing Address - Country:US
Mailing Address - Phone:404-754-5353
Mailing Address - Fax:888-920-0049
Practice Address - Street 1:2295 TOWNE LAKE PKWY
Practice Address - Street 2:SUITE 116-188
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-5520
Practice Address - Country:US
Practice Address - Phone:404-754-5353
Practice Address - Fax:888-920-0049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty