Provider Demographics
NPI:1871195610
Name:CARDINAL COMFORT LLC
Entity type:Organization
Organization Name:CARDINAL COMFORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LAETHEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-964-9770
Mailing Address - Street 1:2118 KARA DR
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-8339
Mailing Address - Country:US
Mailing Address - Phone:989-964-9770
Mailing Address - Fax:
Practice Address - Street 1:2118 KARA DR
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-8339
Practice Address - Country:US
Practice Address - Phone:989-964-9770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty