Provider Demographics
NPI:1740576727
Name:COMPREHENSIVE HEALTH SERVICES
Entity Type:Organization
Organization Name:COMPREHENSIVE HEALTH SERVICES
Other - Org Name:THE SCOOTER STORE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VP
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-760-0700
Mailing Address - Street 1:8229 BOONE BLVD
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2623
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1672 INDEPENDENCE DR
Practice Address - Street 2:BUILDING 2
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-3880
Practice Address - Country:US
Practice Address - Phone:830-627-4722
Practice Address - Fax:830-643-1560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty