Provider Demographics
NPI:1972935781
Name:COMPLETE MEDICAL HEALTHCARE, CORPORATION
Entity Type:Organization
Organization Name:COMPLETE MEDICAL HEALTHCARE, CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:A
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-365-0043
Mailing Address - Street 1:4153 FLAT SHOALS PARKWAY
Mailing Address - Street 2:BUILDING A SUITE.102
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-4106
Mailing Address - Country:US
Mailing Address - Phone:404-241-7062
Mailing Address - Fax:404-243-0357
Practice Address - Street 1:4153 FLAT SHOALS PARKWAY
Practice Address - Street 2:BUILDING A SUITE.102
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-4106
Practice Address - Country:US
Practice Address - Phone:404-241-7062
Practice Address - Fax:404-243-0357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-02
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty