Provider Demographics
NPI:1285808170
Name:ADVANCED COMFORT PAIN CONTROL, INC.
Entity type:Organization
Organization Name:ADVANCED COMFORT PAIN CONTROL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERI
Authorized Official - Middle Name:H
Authorized Official - Last Name:FRANCOEUR
Authorized Official - Suffix:
Authorized Official - Credentials:ATC
Authorized Official - Phone:386-615-4990
Mailing Address - Street 1:PO BOX 1508
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32175-1508
Mailing Address - Country:US
Mailing Address - Phone:386-615-4990
Mailing Address - Fax:386-615-4951
Practice Address - Street 1:533 N NOVA RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-4447
Practice Address - Country:US
Practice Address - Phone:386-615-4990
Practice Address - Fax:386-615-4951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL56332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1182500001Medicare NSC