MEDICARE: KOMFORT KEYPERS 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	343800000X	Secured Medical Transport (VAN)		OH
2	251E00000X	Home Health Agency		OH

General Provider Information

NPI Number	:	1891171013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KOMFORT KEYPERS LLC

Provider Business Mailing Address
First Line	:	5311 NORTHFIELD RD
Second Line	:	SUITE 405 B
City	:	BEDFORD HEIGHTS
State	:	OH
Zip	:	44146-1188
Country	:	US
Telephone Number	:	216-510-7778
Fax Number	:

Provider Business Practice Location Address
First Line	:	5311 NORTHFIELD RD
Second Line	:	SUITE 405 B
City	:	BEDFORD HEIGHTS
State	:	OH
Zip	:	44146-1188
Country	:	US
Telephone Number	:	216-510-7778
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. SAMICA L SUMMERS BETHUNE
Credential	:
Telephone Number	:	216-647-4513

Provider Enumeration Date	:	08/11/2015
Last Update Date	:	12/16/2015

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