Provider Demographics
NPI:1891190138
Name:COMFORT CARE PAIN MANAGEMENT, INC
Entity Type:Organization
Organization Name:COMFORT CARE PAIN MANAGEMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:S
Authorized Official - Last Name:CLIFTON
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:931-484-5379
Mailing Address - Street 1:352 LANTANA RD
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-4912
Mailing Address - Country:US
Mailing Address - Phone:931-484-5379
Mailing Address - Fax:931-484-5946
Practice Address - Street 1:352 LANTANA RD
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-4912
Practice Address - Country:US
Practice Address - Phone:931-484-5379
Practice Address - Fax:931-484-5946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-29
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain