Provider Demographics
NPI:1891022232
Name:COMPREHENSIVE PHYSICIAN ASSOCIATES LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE PHYSICIAN ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:330-759-2511
Mailing Address - Street 1:5170 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1022
Mailing Address - Country:US
Mailing Address - Phone:330-759-2511
Mailing Address - Fax:330-759-5476
Practice Address - Street 1:5170 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1022
Practice Address - Country:US
Practice Address - Phone:330-759-2511
Practice Address - Fax:330-759-5476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35080565207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty