Provider Demographics
NPI:1659005155
Name:CHARITY COMFORT CARE MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:CHARITY COMFORT CARE MEDICAL SUPPLIES
Other - Org Name:CHARITY COMFORT CARE MEDICAL SUPPLIES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-317-6214
Mailing Address - Street 1:3838 OAK LAWN AVE STE 1000
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-4511
Mailing Address - Country:US
Mailing Address - Phone:469-317-6216
Mailing Address - Fax:
Practice Address - Street 1:3838 OAK LAWN AVE STE 1000
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-4511
Practice Address - Country:US
Practice Address - Phone:214-476-5679
Practice Address - Fax:832-390-2505
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHARITY COMFORT CARE SERVICES. LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-12
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No253Z00000XAgenciesIn Home Supportive Care