Provider Demographics
NPI:1306122429
Name:COMFORT CARE TRANSPORTATION
Entity type:Organization
Organization Name:COMFORT CARE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AGOMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-839-2854
Mailing Address - Street 1:1008 W AVENUE J6
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4219
Mailing Address - Country:US
Mailing Address - Phone:661-208-8516
Mailing Address - Fax:
Practice Address - Street 1:1008 W AVENUE J6
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4219
Practice Address - Country:US
Practice Address - Phone:661-208-8516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATCP0028028-B343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATCP0028028-BOtherCPUC NO