Provider Demographics
NPI:1053614842
Name:COMPLETE PAIN CARE
Entity type:Organization
Organization Name:COMPLETE PAIN CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:E
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-304-4133
Mailing Address - Street 1:3650 FOREST HILL BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5662
Mailing Address - Country:US
Mailing Address - Phone:561-304-4133
Mailing Address - Fax:561-304-4134
Practice Address - Street 1:3650 FOREST HILL BLVD STE 3
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5662
Practice Address - Country:US
Practice Address - Phone:561-304-4133
Practice Address - Fax:561-304-4134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2321913336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy