Provider Demographics
NPI:1184991325
Name:PRO COMFORT MEDICAL
Entity type:Organization
Organization Name:PRO COMFORT MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:702-629-6818
Mailing Address - Street 1:101 S RAINBOW BLVD
Mailing Address - Street 2:STE 15
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-5362
Mailing Address - Country:US
Mailing Address - Phone:702-629-6818
Mailing Address - Fax:702-993-8426
Practice Address - Street 1:101 S RAINBOW BLVD
Practice Address - Street 2:STE 15
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-5362
Practice Address - Country:US
Practice Address - Phone:702-629-6818
Practice Address - Fax:702-993-8426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier