Organization
COMPREHENSIVE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT DOUGLAS BLAKE II (OWNER)
(870) 733-1010
Entity
Organization
Contact information
Practice address
648 W BROADWAY ST, WEST MEMPHIS, AR 72301-2907
(870) 733-1010
(870) 733-1011
Mailing address
648 W BROADWAY ST, WEST MEMPHIS, AR 72301-2907
(870) 733-1010
(870) 733-1011
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
MG00601
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1322707
BCBSTN
TN
01
—
49892
BCBS
AR
Enumeration date
03/09/2006
Last updated
03/28/2008
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