Provider Demographics
NPI:1922087824
Name:COMPREHENSIVE MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:COMPREHENSIVE MEDICAL SERVICES INC
Other - Org Name:MOBILITY UNLIMITED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:WIESNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-724-9867
Mailing Address - Street 1:1334 ROMA RD
Mailing Address - Street 2:
Mailing Address - City:HANAHAN
Mailing Address - State:SC
Mailing Address - Zip Code:29410-8522
Mailing Address - Country:US
Mailing Address - Phone:843-724-9867
Mailing Address - Fax:843-724-9869
Practice Address - Street 1:1334 ROMA RD
Practice Address - Street 2:
Practice Address - City:HANAHAN
Practice Address - State:SC
Practice Address - Zip Code:29410-8522
Practice Address - Country:US
Practice Address - Phone:843-724-9867
Practice Address - Fax:843-724-9869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDM0197Medicaid
SCDM0197Medicaid