Provider Demographics
NPI:1891164463
Name:COMPLETE DISPLAY SYSTEMS, INC.
Entity Type:Organization
Organization Name:COMPLETE DISPLAY SYSTEMS, INC.
Other - Org Name:COMFORT KEEPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCNABB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-419-1355
Mailing Address - Street 1:5604 WENDY BAGWELL PKWY
Mailing Address - Street 2:SUITE 811
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-7813
Mailing Address - Country:US
Mailing Address - Phone:770-419-1355
Mailing Address - Fax:770-419-1898
Practice Address - Street 1:5604 WENDY BAGWELL PKWY
Practice Address - Street 2:SUITE 811
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-7813
Practice Address - Country:US
Practice Address - Phone:770-419-1355
Practice Address - Fax:770-419-1898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA110-R-0589253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care