Basic Information
| Provider Information | |||||||||
| NPI: | 1851350334 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMFORT CARE HOME HEALTH SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 245 CAHABA VALLEY PARKWAY | ||||||||
| Address2: | STE 200 | ||||||||
| City: | PELHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059426820 | ||||||||
| FaxNumber: | 8882693065 | ||||||||
| Practice Location | |||||||||
| Address1: | 240 VILLAGE DRIVE | ||||||||
| Address2: | |||||||||
| City: | PELHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2056850421 | ||||||||
| FaxNumber: | 2056850422 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2006 | ||||||||
| LastUpdateDate: | 02/06/2020 | ||||||||
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| AuthorizedOfficialLastName: | STEWART | ||||||||
| AuthorizedOfficialFirstName: | RONALD | ||||||||
| AuthorizedOfficialMiddleName: | ALAN | ||||||||
| AuthorizedOfficialTitleorPosition: | COO | ||||||||
| AuthorizedOfficialTelephone: | 2059265278 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | COM7153A | 05 | AL | MEDICAID |