MEDICARE: COMFORT HOMES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1679308548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMFORT HOMES LLC

Provider Business Mailing Address
First Line	:	11415 AMIGO AVE
Second Line	:
City	:	PORTER RANCH
State	:	CA
Zip	:	91326-2119
Country	:	US
Telephone Number	:	818-284-0757
Fax Number	:

Provider Business Practice Location Address
First Line	:	11415 AMIGO AVE
Second Line	:
City	:	PORTER RANCH
State	:	CA
Zip	:	91326-2119
Country	:	US
Telephone Number	:	818-284-0757
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	VICTORIA A OGUNDEKO
Credential	:
Telephone Number	:	818-284-0757

Provider Enumeration Date	:	09/03/2024
Last Update Date	:	09/03/2024

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