Healthcare Provider Details

I. General information

NPI: 1902424013
Provider Name (Legal Business Name): COMFORT MEDICAL SUPPLIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 07/06/2020
Certification Date: 07/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2419 W JEFFERSON ST
JOLIET IL
60435-6462
US

IV. Provider business mailing address

530 S PRINCETON AVE
VILLA PARK IL
60181-2858
US

V. Phone/Fax

Practice location:
  • Phone: 630-796-1167
  • Fax:
Mailing address:
  • Phone: 630-796-1167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. AAMIR KHAN
Title or Position: OWNER
Credential:
Phone: 630-796-1167