1689671018 NPI number — COMFORT CARE MEDICAL EQUIPMENT, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689671018 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:
1689671018
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:
405 FREDERICK ROAD
Provider Second Line Business Practice Location Address:
SUITE 158A
Provider Business Practice Location Address City Name:
CATONSVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21228-4633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-788-1881
Provider Business Practice Location Address Fax Number:
410-788-1882
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: 332B00000X , with the licence number:  03326185 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 53379701 . This is a "CAREFIRST BC BS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 533797-03 . This is a "CAREFIRST-BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 336248500-03 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: F716-0001 . This is a "F.E.P.I. BLUE COICE" identifier . This identifiers is of the category "OTHER".




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