Healthcare Provider Details

I. General information

NPI: 1376586057
Provider Name (Legal Business Name): COMFORT CARE MEDICAL SUPPLIES & RENTALS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 10/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1665 N MAGNOLIA AVE
OCALA FL
34475-9108
US

IV. Provider business mailing address

1665 N MAGNOLIA AVE
OCALA FL
34475-9108
US

V. Phone/Fax

Practice location:
  • Phone: 352-867-0202
  • Fax: 352-291-0202
Mailing address:
  • Phone: 352-867-0202
  • Fax: 352-291-0202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1312143
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number32-6748
License Number StateFL

VIII. Authorized Official

Name: JAMES ROBERT FLETCHER
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 352-867-0202