Provider Demographics
NPI:1497875124
Name:BRY & WMS MEDICAL INC
Entity Type:Organization
Organization Name:BRY & WMS MEDICAL INC
Other - Org Name:COMFOR CARE SENIOR SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-545-6051
Mailing Address - Street 1:4371 UNION DEPOSIT RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111
Mailing Address - Country:US
Mailing Address - Phone:717-545-6051
Mailing Address - Fax:717-695-6406
Practice Address - Street 1:4371 UNION DEPOSIT RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111
Practice Address - Country:US
Practice Address - Phone:717-545-6051
Practice Address - Fax:717-695-6406
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRY & WMS MEDICAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-29
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018081080001Medicaid