1336944370 NPI number — COMPREHAB LLC

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 1336944370 NPI number — COMPREHAB LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPREHAB LLC
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:
Provider Other Organization Name Type Code:
6
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:
1336944370
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 749
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELMONT
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28012-0749
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-580-6180
Provider Business Mailing Address Fax Number:
980-866-4741

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
512 WESTOVER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24541-4104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-548-0334
Provider Business Practice Location Address Fax Number:
434-425-0990
Provider Enumeration Date:
02/14/2025

Additional Information

Authorized Official

Authorized Official Last Name:
QUILLEN
Authorized Official First Name:
HEATHER
Authorized Official Middle Name:
Authorized Official Title or Position:
PAYER RELATIONS
Authorized Official Telephone Number:
704-271-1213

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 300151999930002 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 720132B , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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