Provider Demographics
NPI:1669570172
Name:COMFORT & CARE MEDICAL SUPPLIES, INC
Entity type:Organization
Organization Name:COMFORT & CARE MEDICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-450-4155
Mailing Address - Street 1:515 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4604
Mailing Address - Country:US
Mailing Address - Phone:713-450-4155
Mailing Address - Fax:713-450-4177
Practice Address - Street 1:515 E 1ST ST
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4604
Practice Address - Country:US
Practice Address - Phone:713-450-4155
Practice Address - Fax:713-450-4177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0033422332BP3500X, 332BX2000X, 332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX016325501Medicaid
TX519660OtherBCBS OF TEXAS
TX010543901Medicaid
TX0105439-01Medicaid