Provider Demographics
NPI:1508260159
Name:COMFY RIDE LLC
Entity Type:Organization
Organization Name:COMFY RIDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HIWOT
Authorized Official - Middle Name:
Authorized Official - Last Name:DESTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-789-0881
Mailing Address - Street 1:1295 SEVEN SPRINGS CIR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-2677
Mailing Address - Country:US
Mailing Address - Phone:404-789-0118
Mailing Address - Fax:770-627-3922
Practice Address - Street 1:1295 SEVEN SPRINGS CIR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2677
Practice Address - Country:US
Practice Address - Phone:404-789-0118
Practice Address - Fax:770-627-3922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-10
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOCC009191343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)