Provider Demographics
NPI:1790865988
Name:COMPLIANCE MEDICAL SERVICES
Entity Type:Organization
Organization Name:COMPLIANCE MEDICAL SERVICES
Other - Org Name:GARDEN CITY HOSPITAL PROFESSIONAL STAFF PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOVALIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-357-1215
Mailing Address - Street 1:33300 FIVE MILE RD
Mailing Address - Street 2:STE 210
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154
Mailing Address - Country:US
Mailing Address - Phone:313-357-1215
Mailing Address - Fax:313-357-1173
Practice Address - Street 1:33300 FIVE MILE RD
Practice Address - Street 2:STE 210
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154
Practice Address - Country:US
Practice Address - Phone:313-357-1215
Practice Address - Fax:313-357-1173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization