Provider Demographics
NPI:1154667814
Name:LINCARE PULMONARY REHAB SERVICES OF OHIO, LLC
Entity Type:Organization
Organization Name:LINCARE PULMONARY REHAB SERVICES OF OHIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NANNIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:7274-530-7700
Mailing Address - Street 1:19387 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-3102
Mailing Address - Country:US
Mailing Address - Phone:727-431-8261
Mailing Address - Fax:877-524-9504
Practice Address - Street 1:3950 SUNFOREST CT
Practice Address - Street 2:STE 104
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4485
Practice Address - Country:US
Practice Address - Phone:419-474-5039
Practice Address - Fax:419-474-5052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-27
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty