MEDICARE: SOLE E COMFORT AND FOOTCARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1083879159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLE E COMFORT AND FOOTCARE LLC

Provider Business Mailing Address
First Line	:	1045 ROUTE 70 # C-5
Second Line	:
City	:	MANCHESTER
State	:	NJ
Zip	:	08759-5806
Country	:	US
Telephone Number	:	732-284-8133
Fax Number	:	732-279-0161

Provider Business Practice Location Address
First Line	:	1045 ROUTE 70 # C-5
Second Line	:
City	:	MANCHESTER
State	:	NJ
Zip	:	08759-5806
Country	:	US
Telephone Number	:	732-284-8133
Fax Number	:	732-279-0161

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MRS. PATRICIA LEVY
Credential	:
Telephone Number	:	732-284-8133

Provider Enumeration Date	:	07/28/2008
Last Update Date	:	07/20/2009

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