Provider Demographics
NPI:1265853337
Name:COMFORT IV THERAPY
Entity Type:Organization
Organization Name:COMFORT IV THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEVI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:941-355-8330
Mailing Address - Street 1:1800 NORTHGATE BLVD
Mailing Address - Street 2:SUITE A7
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234
Mailing Address - Country:US
Mailing Address - Phone:941-355-8330
Mailing Address - Fax:941-355-8322
Practice Address - Street 1:1800 NORTHGATE BLVD
Practice Address - Street 2:SUITE A7
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234
Practice Address - Country:US
Practice Address - Phone:941-355-8330
Practice Address - Fax:941-355-8322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-17
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL45954332BP3500X, 3336S0011X
3336C0003X, 3336C0004X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7231550001OtherMEDICARE PTAN