Provider Demographics
NPI:1023388709
Name:MIDWEST RESPIRATORY CARE INC
Entity Type:Organization
Organization Name:MIDWEST RESPIRATORY CARE INC
Other - Org Name:BLAIR MEDICAL SUPPLY AND HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:DELASHMUTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-592-2435
Mailing Address - Street 1:9931 S 136TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-3937
Mailing Address - Country:US
Mailing Address - Phone:402-592-2435
Mailing Address - Fax:402-592-6914
Practice Address - Street 1:1215 E 17TH ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-3264
Practice Address - Country:US
Practice Address - Phone:402-948-4700
Practice Address - Fax:402-592-6914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA93895OtherBLUE CROSS BLUE SHIELD
IA0599704Medicaid
NE09870OtherBLUE CROSS BLUE SHIELD
NE10025327700Medicaid
IA0599704Medicaid