Provider Demographics
NPI:1154379378
Name:COMPREHENSIVE HOME CARE INC
Entity type:Organization
Organization Name:COMPREHENSIVE HOME CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHCY MNGR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH BAZAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:305-235-1072
Mailing Address - Street 1:12916 SW 132ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5819
Mailing Address - Country:US
Mailing Address - Phone:305-235-1072
Mailing Address - Fax:305-235-1087
Practice Address - Street 1:12916 SW 132ND CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5819
Practice Address - Country:US
Practice Address - Phone:305-235-1072
Practice Address - Fax:305-235-1087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH00142083336C0003X
3336C0004X, 3336H0001X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1081847OtherNCPDP PROVIDER IDENTIFICATION NUMBER
FL106060100Medicaid
1081847OtherNCPDP PROVIDER IDENTIFICATION NUMBER