=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578843264
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMFORT LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/25/2011
-----------------------------------------------------
Last Update Date | 08/25/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 165 DYERVILLE AVE SUITE #4
-----------------------------------------------------
City | JOHNSTON
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02919-4400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-369-7799
-----------------------------------------------------
Fax | 401-369-7755
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 165 DYERVILLE AVE SUITE #4
-----------------------------------------------------
City | JOHNSTON
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02919-4400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-369-7799
-----------------------------------------------------
Fax | 401-369-7755
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | MR. OGANESS JOHN GEVORKIAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-333-6170
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | HNC02359
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------