Provider Demographics
NPI:1093938011
Name:COMFORT CARE HOME HEALTH, INC.
Entity Type:Organization
Organization Name:COMFORT CARE HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOALS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-767-6221
Mailing Address - Street 1:4801 N CLASSEN BLVD
Mailing Address - Street 2:SUITE 245
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-4627
Mailing Address - Country:US
Mailing Address - Phone:405-767-6221
Mailing Address - Fax:405-767-6282
Practice Address - Street 1:4801 N CLASSEN BLVD
Practice Address - Street 2:SUITE 245
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-4627
Practice Address - Country:US
Practice Address - Phone:405-767-6221
Practice Address - Fax:405-767-6282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7848251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health