Organization
PACIFIC PEDORTHIC SERVICES
Active
Other names
Pro Comfort Medical
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN HIGHAM CPED (PRESIDENT)
(702) 629-6818
Entity
Organization
Contact information
Practice address
106 S JONES BLVD, LAS VEGAS, NV 89107-2614
(702) 629-6818
(702) 993-8426
Mailing address
106 S JONES BLVD, LAS VEGAS, NV 89107-2614
(702) 629-6818
(702) 993-8426
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808067500
—
ID
05
—
9058868
—
WA
05
—
9061094
—
WA
05
—
9061110
—
WA
Enumeration date
05/17/2007
Last updated
03/02/2020
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