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General NPI Number Information
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NPI Number | 1083960868
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Entity Type | Organization
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Legal Business Name | COMFORTING SOLES 2
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 181 W VALLEY AVE STE 209
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City | BIRMINGHAM
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State | AL
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Zip | 35209-3600
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Country | US
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Telephone | 205-536-6009
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Fax | 800-976-5001
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Provider Business Mailing Address
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Address Line | 1813 CEDAR GROVE RD
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City | CONLEY
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State | GA
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Zip | 30288-1301
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Country | US
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Telephone | 404-468-6744
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Fax | 800-401-2230
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSHUA BIVINS
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Credential | CFST
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Telephone | 470-558-5038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | GA
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