MEDICARE: COMFORT MEDICAL SUPPLY, INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies	0206009926	VA

General Provider Information

NPI Number	:	1790230381
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMFORT MEDICAL SUPPLY, INC.

Provider Business Mailing Address
First Line	:	1273 CENTRAL PARK BLVD
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22401-4912
Country	:	US
Telephone Number	:	540-785-3202
Fax Number	:	540-785-3203

Provider Business Practice Location Address
First Line	:	1273 CENTRAL PARK BLVD
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22401-4912
Country	:	US
Telephone Number	:	540-785-3202
Fax Number	:	540-785-3203

Authorized Official
Title or Position	:	VICE-PRESIDENT
Name	:	MR. LAWRENCE FILKOSKI JR.
Credential	:
Telephone Number	:	540-785-3202

Provider Enumeration Date	:	08/24/2016
Last Update Date	:	08/24/2016

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