Healthcare Provider Details
I. General information
NPI: 1275924664
Provider Name (Legal Business Name): COMFORT MED. SUPPLY, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2015
Last Update Date: 02/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9450 E MISSISSIPPI AVE # F
DENVER CO
80247-2427
US
IV. Provider business mailing address
9450 E MISSISSIPPI AVE # F
DENVER CO
80247-2427
US
V. Phone/Fax
- Phone: 303-750-0804
- Fax: 303-600-7997
- Phone: 303-750-0804
- Fax: 303-600-7997
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MIKHAIL
DVORKIN
Title or Position: OWNER
Credential:
Phone: 303-750-0804