1396742888 NPI number — COMFORT CARE MEDICAL EQUIPMENT, INC

Table of content: (NPI 1396742888)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396742888 NPI number — COMFORT CARE MEDICAL EQUIPMENT, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMFORT CARE MEDICAL EQUIPMENT, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396742888
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7801 YORK ROAD
Provider Second Line Business Mailing Address:
SUITE 336
Provider Business Mailing Address City Name:
TOWSON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21204-7449
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-828-0947
Provider Business Mailing Address Fax Number:
410-828-8967

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1105 NORTH POINT BLVD
Provider Second Line Business Practice Location Address:
STE 325
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21224-3418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-282-9660
Provider Business Practice Location Address Fax Number:
410-282-9661
Provider Enumeration Date:
06/30/2005

Additional Information

Authorized Official

Authorized Official Last Name:
CHALMERS
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
443-519-2113

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: 03326185 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 33624850002 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 336248500-02 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 53379701 . This is a "CAREFIRST BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: F7150001 . This is a "BS FEDERAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: S3379702 . This is a "CAREFIRST BCBS" identifier . This identifiers is of the category "OTHER".




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