Provider Demographics
NPI:1407882566
Name:VALLEYAIRE RESPIRATORY SERVICES INC
Entity Type:Organization
Organization Name:VALLEYAIRE RESPIRATORY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-891-2330
Mailing Address - Street 1:15112 GALAXIE AVE
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-6985
Mailing Address - Country:US
Mailing Address - Phone:952-891-1713
Mailing Address - Fax:952-891-4625
Practice Address - Street 1:15112 GALAXIE AVE
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-6985
Practice Address - Country:US
Practice Address - Phone:952-891-1713
Practice Address - Fax:952-891-4625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5732880001Medicare NSC