Provider Demographics
NPI:1538480769
Name:FBMC TRIBUTE INC
Entity Type:Organization
Organization Name:FBMC TRIBUTE INC
Other - Org Name:COMFORCARE SENIOR SERVICES - COLLIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ACHU
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILIPOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-361-1330
Mailing Address - Street 1:3401 CUSTER RD STE 128
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-7553
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3401 CUSTER RD STE 128
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-7553
Practice Address - Country:US
Practice Address - Phone:469-361-1330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2012-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care