Provider Demographics
NPI:1427493543
Name:COMPREHENSIVE CARE MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:COMPREHENSIVE CARE MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JO
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-261-5755
Mailing Address - Street 1:1609 WOODBOURNE RD
Mailing Address - Street 2:SUITE 202B
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19057-1500
Mailing Address - Country:US
Mailing Address - Phone:215-949-8300
Mailing Address - Fax:215-949-8301
Practice Address - Street 1:1609 WOODBOURNE RD
Practice Address - Street 2:SUITE 202B
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19057-1500
Practice Address - Country:US
Practice Address - Phone:215-949-8300
Practice Address - Fax:215-949-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA141120Medicare PIN