Provider Demographics
NPI:1376508291
Name:TOTAL RESPIRATORY CARE INC
Entity Type:Organization
Organization Name:TOTAL RESPIRATORY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KORY
Authorized Official - Middle Name:S
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-298-8831
Mailing Address - Street 1:1593 W 2350 S
Mailing Address - Street 2:SUITE C
Mailing Address - City:WOODS CROSS
Mailing Address - State:UT
Mailing Address - Zip Code:84087-2399
Mailing Address - Country:US
Mailing Address - Phone:801-298-8831
Mailing Address - Fax:801-298-2549
Practice Address - Street 1:1593 W 2350 S
Practice Address - Street 2:SUITE C
Practice Address - City:WOODS CROSS
Practice Address - State:UT
Practice Address - Zip Code:84087-2399
Practice Address - Country:US
Practice Address - Phone:801-298-8831
Practice Address - Fax:801-298-2549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT53625441714332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========005Medicaid
UT1112420001Medicare NSC