MEDICARE: COMFORT MEDICAL SUPPLY 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		TX

General Provider Information

NPI Number	:	1801167648
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMFORT MEDICAL SUPPLY LLC

Provider Business Mailing Address
First Line	:	600 CENTURY PLAZA DR
Second Line	:	STE C-110
City	:	HOUSTON
State	:	TX
Zip	:	77073-6128
Country	:	US
Telephone Number	:	281-645-4960
Fax Number	:	281-645-4964

Provider Business Practice Location Address
First Line	:	600 CENTURY PLAZA DR
Second Line	:	STE C-110
City	:	HOUSTON
State	:	TX
Zip	:	77073-6128
Country	:	US
Telephone Number	:	281-645-4960
Fax Number	:	281-645-4964

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	CRAIG A DALEY
Credential	:
Telephone Number	:	386-673-6902

Provider Enumeration Date	:	01/25/2012
Last Update Date	:	01/25/2012

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