Provider Demographics
NPI:1790128700
Name:COMPREHENSIVE INTERVENTIONAL CARE
Entity Type:Organization
Organization Name:COMPREHENSIVE INTERVENTIONAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAINWATER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-818-5635
Mailing Address - Street 1:21297 N 110TH WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3391
Mailing Address - Country:US
Mailing Address - Phone:480-219-0123
Mailing Address - Fax:
Practice Address - Street 1:6309 E BAYWOOD AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1744
Practice Address - Country:US
Practice Address - Phone:480-818-5635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-09
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty