Provider Demographics
NPI:1700124682
Name:COMPREHENSIVE CONTINGENCY TASK FORCE
Entity Type:Organization
Organization Name:COMPREHENSIVE CONTINGENCY TASK FORCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:706-221-5025
Mailing Address - Street 1:502 W CENTER CROSS ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:46124-9701
Mailing Address - Country:US
Mailing Address - Phone:812-526-4070
Mailing Address - Fax:
Practice Address - Street 1:3649 VICTORY DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31903-4553
Practice Address - Country:US
Practice Address - Phone:706-221-5025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26XFNKR00OtherHIN NUMBER