Provider Demographics
NPI:1336141589
Name:RESPIRATORY SERVICES OF NORTHWEST FLORIDA, INC.
Entity Type:Organization
Organization Name:RESPIRATORY SERVICES OF NORTHWEST FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:E
Authorized Official - Last Name:ENFINGER
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:850-689-5499
Mailing Address - Street 1:502 E PINE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-2818
Mailing Address - Country:US
Mailing Address - Phone:850-689-5499
Mailing Address - Fax:850-689-5404
Practice Address - Street 1:502 E PINE AVE STE B
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-2818
Practice Address - Country:US
Practice Address - Phone:850-689-5499
Practice Address - Fax:850-689-5404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7097332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL951941600Medicaid
1151010001Medicare ID - Type UnspecifiedMEDICARE ID NUMBER