Provider Demographics
NPI:1336141092
Name:NATIONAL HOME RESPIRATORY CARE OF NORTHEAST FLORIDA, INC.
Entity Type:Organization
Organization Name:NATIONAL HOME RESPIRATORY CARE OF NORTHEAST FLORIDA, INC.
Other - Org Name:NATIONAL HOME CARE SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:LESHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-349-2868
Mailing Address - Street 1:1830 OAKLAND AVE STE 145
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3359
Mailing Address - Country:US
Mailing Address - Phone:724-349-2868
Mailing Address - Fax:724-349-2865
Practice Address - Street 1:1830 OAKLAND AVE STE 145
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3359
Practice Address - Country:US
Practice Address - Phone:724-349-2868
Practice Address - Fax:724-349-2865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR132861741Medicaid
GA000709959AMedicaid
FL0257567-00Medicaid
FL950036700Medicaid
MS00440496Medicaid
TN4581939Medicaid
MN7394624-00Medicaid
SCDE2245Medicaid
IA0993758Medicaid
TXDME00M584Medicaid
AL009964075Medicaid
OH2044906Medicaid
NC7703775Medicaid
VA9115536Medicaid
NE100249728-00Medicaid
WI12144100Medicaid
GA000709959BMedicaid
MD0324001 00Medicaid
SCDE2245Medicaid
FL950036700Medicaid