Provider Demographics
NPI:1043203623
Name:RESPIRATORY AT HOME PLUS
Entity Type:Organization
Organization Name:RESPIRATORY AT HOME PLUS
Other - Org Name:OXYGEN PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-728-0028
Mailing Address - Street 1:110 OAKCREST DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NC
Mailing Address - Zip Code:28752-4976
Mailing Address - Country:US
Mailing Address - Phone:828-659-8222
Mailing Address - Fax:828-659-8220
Practice Address - Street 1:110 OAKCREST DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-4976
Practice Address - Country:US
Practice Address - Phone:828-659-8222
Practice Address - Fax:828-659-8220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-29
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00555332BX2000X
333600000X
NC092663336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0595215Medicaid
NC7703776Medicaid
3405316OtherNCPDP PROVIDER IDENTIFICATION NUMBER
3405316OtherNCPDP PROVIDER IDENTIFICATION NUMBER