Provider Demographics
NPI:1336244110
Name:COMPREHENSIVE PHARMACY SERVICES LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE PHARMACY SERVICES LLC
Other - Org Name:COMPREHENSIVE PHARMACY SERVICES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT, CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-816-2499
Mailing Address - Street 1:655 METRO PL S STE 450
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-3388
Mailing Address - Country:US
Mailing Address - Phone:901-748-0470
Mailing Address - Fax:614-766-0101
Practice Address - Street 1:58 GARNET WAY
Practice Address - Street 2:
Practice Address - City:WARM SPRINGS
Practice Address - State:MT
Practice Address - Zip Code:59756
Practice Address - Country:US
Practice Address - Phone:406-693-7178
Practice Address - Fax:406-693-7181
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPREHENSIVE PHARMACY SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-14
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9703336L0003X
MT13423336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT214591Medicaid