Provider Demographics
NPI:1053062281
Name:CHARLOTTE LASTER
Entity Type:Organization
Organization Name:CHARLOTTE LASTER
Other - Org Name:COMFORT AND CARE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:LASTER
Authorized Official - Suffix:
Authorized Official - Credentials:CMA, CPT, X-RAY TECH
Authorized Official - Phone:601-507-0856
Mailing Address - Street 1:231 S VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MS
Mailing Address - Zip Code:39051-4047
Mailing Address - Country:US
Mailing Address - Phone:601-654-2087
Mailing Address - Fax:
Practice Address - Street 1:231 S VALLEY ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MS
Practice Address - Zip Code:39051-4047
Practice Address - Country:US
Practice Address - Phone:601-654-2087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health