Healthcare Provider Details

I. General information

NPI: 1639468200
Provider Name (Legal Business Name): COMOMITIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 08/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2891 RICHMOND RD SUITE 102
LEXINGTON KY
40509-1720
US

IV. Provider business mailing address

2891 RICHMOND RD SUITE 102
LEXINGTON KY
40509-1720
US

V. Phone/Fax

Practice location:
  • Phone: 859-335-5949
  • Fax: 859-269-0863
Mailing address:
  • Phone: 859-335-5949
  • Fax: 859-269-0863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. CERISE BOUCHARD
Title or Position: OWNER
Credential: CLC
Phone: 859-335-5949