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Organization

COMFORT PLUS SHOE CENTER, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBORAH LYNN MANNINO (PRESIDENT, CPED)
(402) 392-2952
Entity
Organization

Contact information

Practice address
535 N 155TH PLZ, OMAHA, NE 68154-3775
(402) 392-2952
(402) 392-1761
Mailing address
535 N 155TH PLZ, OMAHA, NE 68154-3775
(402) 392-2952
(402) 392-1761

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
7077181
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0939116
IA
01
09980
BLUE CROSS BLUE SHIELD
NE
05
10025318500
NE
Enumeration date
03/26/2008
Last updated
01/15/2009
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