Provider Demographics
NPI:1164758660
Name:ADVANCED IN HOME RESPIRATORY 24, LLC
Entity Type:Organization
Organization Name:ADVANCED IN HOME RESPIRATORY 24, LLC
Other - Org Name:AIR 24
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:DOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-235-5945
Mailing Address - Street 1:5003 N ILLINOIS ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FAIRVIEW HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:62208-3419
Mailing Address - Country:US
Mailing Address - Phone:618-235-5945
Mailing Address - Fax:618-235-5985
Practice Address - Street 1:5003 N ILLINOIS ST
Practice Address - Street 2:SUITE 1
Practice Address - City:FAIRVIEW HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:62208-3419
Practice Address - Country:US
Practice Address - Phone:618-235-5945
Practice Address - Fax:618-235-5985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies