Provider Demographics
NPI:1336414804
Name:PHOENIX COMPREHENSIVE HEALTH CARE SERVICES,LLC
Entity type:Organization
Organization Name:PHOENIX COMPREHENSIVE HEALTH CARE SERVICES,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:615-339-4298
Mailing Address - Street 1:515 RIVERGATE PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-2025
Mailing Address - Country:US
Mailing Address - Phone:615-239-8359
Mailing Address - Fax:
Practice Address - Street 1:515 RIVERGATE PKWY STE 102
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2025
Practice Address - Country:US
Practice Address - Phone:615-239-8359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-17
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty