Provider Demographics
NPI:1952636763
Name:COMCARE MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:COMCARE MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TUSHAR
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHAUHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-795-5952
Mailing Address - Street 1:1000 S BURNT MILL RD
Mailing Address - Street 2:STE B
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2215
Mailing Address - Country:US
Mailing Address - Phone:856-795-5952
Mailing Address - Fax:856-795-5951
Practice Address - Street 1:1000 S BURNT MILL RD
Practice Address - Street 2:STE B
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2215
Practice Address - Country:US
Practice Address - Phone:856-795-5952
Practice Address - Fax:856-795-5951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-12
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical