Provider Demographics
NPI:1508045261
Name:AVATAR ENTERPRISES
Entity Type:Organization
Organization Name:AVATAR ENTERPRISES
Other - Org Name:COMFORTEX, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:TEREK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-454-6579
Mailing Address - Street 1:1680 WILKIE DR
Mailing Address - Street 2:PO BOX 850
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-6202
Mailing Address - Country:US
Mailing Address - Phone:507-454-6579
Mailing Address - Fax:507-454-6581
Practice Address - Street 1:1680 WILKIE DR
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-6202
Practice Address - Country:US
Practice Address - Phone:507-454-6579
Practice Address - Fax:507-454-6581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies