Provider Demographics
NPI:1174772404
Name:COMFORT FEET, LLC
Entity type:Organization
Organization Name:COMFORT FEET, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:SHELDON
Authorized Official - Last Name:STARK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:334-749-1213
Mailing Address - Street 1:2486 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-1516
Mailing Address - Country:US
Mailing Address - Phone:334-749-1213
Mailing Address - Fax:334-749-1699
Practice Address - Street 1:2486 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-1516
Practice Address - Country:US
Practice Address - Phone:334-749-1213
Practice Address - Fax:334-749-1699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1585332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies