Provider Demographics
NPI:1750468666
Name:COMPREHENSIVE PAIN MANAGEMENT CENTERS INC.
Entity Type:Organization
Organization Name:COMPREHENSIVE PAIN MANAGEMENT CENTERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SAMARASINGHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-725-7364
Mailing Address - Street 1:5372 FALLOWATER LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-0903
Mailing Address - Country:US
Mailing Address - Phone:540-725-7364
Mailing Address - Fax:540-725-7368
Practice Address - Street 1:5372 FALLOWATER LN
Practice Address - Street 2:SUITE A
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-0903
Practice Address - Country:US
Practice Address - Phone:540-725-7364
Practice Address - Fax:540-725-7368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06534Medicare ID - Type UnspecifiedMEDICARE ID