Provider Demographics
NPI:1376578948
Name:PRO2 RESPIRATORY SERVICES, LLC
Entity Type:Organization
Organization Name:PRO2 RESPIRATORY SERVICES, LLC
Other - Org Name:PRO2 RESPIRATORY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCHDEACON
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:513-469-7702
Mailing Address - Street 1:5800 CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4010
Mailing Address - Country:US
Mailing Address - Phone:513-469-7702
Mailing Address - Fax:513-469-7707
Practice Address - Street 1:5800 CREEK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4010
Practice Address - Country:US
Practice Address - Phone:513-469-7702
Practice Address - Fax:513-469-7707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200225840AMedicaid
OH2117882Medicaid
KY90272451Medicaid
KY90272451Medicaid