Provider Demographics
NPI:1083109219
Name:DOCMAC COMFORT CARE LLC
Entity Type:Organization
Organization Name:DOCMAC COMFORT CARE LLC
Other - Org Name:FRANK MCDONALD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-617-0380
Mailing Address - Street 1:PO BOX 901
Mailing Address - Street 2:
Mailing Address - City:ROCIADA
Mailing Address - State:NM
Mailing Address - Zip Code:87742-0901
Mailing Address - Country:US
Mailing Address - Phone:505-617-0380
Mailing Address - Fax:
Practice Address - Street 1:2301 COLLINS DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4826
Practice Address - Country:US
Practice Address - Phone:505-425-9362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty