Provider Demographics
NPI:1770750150
Name:COMFORT SHOE FIT
Entity type:Organization
Organization Name:COMFORT SHOE FIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RANI
Authorized Official - Middle Name:
Authorized Official - Last Name:KATHAMUTHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-533-8333
Mailing Address - Street 1:2301 B WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-3808
Mailing Address - Country:US
Mailing Address - Phone:915-533-8333
Mailing Address - Fax:915-533-8350
Practice Address - Street 1:2301 B WYOMING AVENUE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-3808
Practice Address - Country:US
Practice Address - Phone:915-533-8333
Practice Address - Fax:915-533-8350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment