Organization
COMFORT CARE HOME HEALTH AGENCY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLIN SUE CROCKETT RN (CEO/PRESIDENT)
(573) 996-3524
Entity
Organization
Contact information
Practice address
1415 WALNUT ST, DONIPHAN, MO 63935-1016
(573) 996-3524
(573) 996-4531
Mailing address
1415 WALNUT ST, DONIPHAN, MO 63935-1016
(573) 996-3524
(573) 996-4531
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
546-6
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112511
BC/BS NUMBER
MO
05
—
588583500
—
MO
Enumeration date
05/24/2005
Last updated
06/08/2010
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