Provider Demographics
NPI:1093019606
Name:AIRTIME RESPIRATORY CARE
Entity Type:Organization
Organization Name:AIRTIME RESPIRATORY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALPHONSO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHISLOM
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:951-378-2083
Mailing Address - Street 1:3638 UNIVERSITY AVE STE 248
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-3331
Mailing Address - Country:US
Mailing Address - Phone:951-378-2083
Mailing Address - Fax:951-328-1854
Practice Address - Street 1:3638 UNIVERSITY AVE STE 248
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3331
Practice Address - Country:US
Practice Address - Phone:951-378-2083
Practice Address - Fax:951-328-1854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-23
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty