1083860399 NPI number — COMPRECARE SERVICES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083860399 NPI number — COMPRECARE SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPRECARE SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
A PLUS MEDICAL EQUIPMENT
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083860399
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 385
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25541-0385
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-390-0130
Provider Business Mailing Address Fax Number:
304-390-0137

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1807 W PIKE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLARKSBURG
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26301-2382
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-326-2050
Provider Business Practice Location Address Fax Number:
304-326-2051
Provider Enumeration Date:
08/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
PARSONS
Authorized Official First Name:
LORA
Authorized Official Middle Name:
G
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
304-390-0130

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0670939 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0144228004 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90269044 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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