Provider Demographics
NPI:1013030667
Name:COMFORT MEDICAL SUPPLY
Entity type:Organization
Organization Name:COMFORT MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:I
Authorized Official - Last Name:BANDELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-795-6615
Mailing Address - Street 1:34664 COUNTY LINE RD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-5309
Mailing Address - Country:US
Mailing Address - Phone:909-795-6615
Mailing Address - Fax:909-795-6607
Practice Address - Street 1:34664 COUNTY LINE RD
Practice Address - Street 2:SUITE 14
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399
Practice Address - Country:US
Practice Address - Phone:909-795-6615
Practice Address - Fax:909-795-6607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47200332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies