Provider Demographics
NPI:1346417458
Name:NATIONAL RESPIRATORY MEDICAL COMPANY
Entity Type:Organization
Organization Name:NATIONAL RESPIRATORY MEDICAL COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-382-1006
Mailing Address - Street 1:4409 SUN N LAKE BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-2170
Mailing Address - Country:US
Mailing Address - Phone:863-382-1006
Mailing Address - Fax:863-382-3004
Practice Address - Street 1:4409 SUN N LAKE BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-2170
Practice Address - Country:US
Practice Address - Phone:863-382-1006
Practice Address - Fax:863-382-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL326686332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003276700Medicaid
FLR000AOtherBCBS
FL003276700Medicaid
FLR000AOtherBCBS