Provider Demographics
NPI:1023734795
Name:COMFORT CARE DME LLC
Entity type:Organization
Organization Name:COMFORT CARE DME LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJEEV
Authorized Official - Middle Name:
Authorized Official - Last Name:JOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-342-6530
Mailing Address - Street 1:PO BOX 61
Mailing Address - Street 2:
Mailing Address - City:NEW HUDSON
Mailing Address - State:MI
Mailing Address - Zip Code:48165-0061
Mailing Address - Country:US
Mailing Address - Phone:248-342-6530
Mailing Address - Fax:586-200-0355
Practice Address - Street 1:26645 W 12 MILE RD STE 201
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-7812
Practice Address - Country:US
Practice Address - Phone:248-342-6530
Practice Address - Fax:586-200-0355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies