Healthcare Provider Details

I. General information

NPI: 1396778429
Provider Name (Legal Business Name): JJL&W INC. T/A KOMFORT & KARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 01/12/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 N WHITE HORSE PIKE
MAGNOLIA NJ
08049-1405
US

IV. Provider business mailing address

424 N WHITE HORSE PIKE
MAGNOLIA NJ
08049-1405
US

V. Phone/Fax

Practice location:
  • Phone: 856-854-3100
  • Fax:
Mailing address:
  • Phone: 856-854-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number0075846
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0075846
License Number StateNJ

VIII. Authorized Official

Name: MR. SETH AUERBACH
Title or Position: PRESIDENT
Credential:
Phone: 856-854-3100