Provider Demographics
NPI:1144343724
Name:COMHAR INC
Entity type:Organization
Organization Name:COMHAR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TRAPETA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MAYSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-541-9204
Mailing Address - Street 1:100 W LEHIGH AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19133-4039
Mailing Address - Country:US
Mailing Address - Phone:215-203-3037
Mailing Address - Fax:215-203-3078
Practice Address - Street 1:2055 E ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-3832
Practice Address - Country:US
Practice Address - Phone:215-203-3037
Practice Address - Fax:215-203-3078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
PA104560251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PW1000004060112Medicaid
PA600001921OtherMAGELLAN 19133 3849
PA600001922OtherMAGELLAN 19149 1229
PA600001925OtherMAGELLAN 19121 2217
PA600001928OtherMAGELLAN 19144 2153
PA1000004060107Medicaid
PA1000004060109Medicaid
PA1000004060111Medicaid
PA1000004060110Medicaid
PA600001917OtherMAGELLAN 19134 3832
PA1000004060136Medicaid
PA1000004060137Medicaid
PA600001919OtherMAGELLAN 19107 1913
PA1000004060108Medicaid
PA1000004060138Medicaid
PA600001923OtherMAGELLAN 19104 1361
PA1000004060108Medicaid