Provider Demographics
NPI:1447237573
Name:RICHMOND RESPIRATORY & MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:RICHMOND RESPIRATORY & MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:BERRY
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:804-745-9677
Mailing Address - Street 1:1108 COURTHOUSE RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-3197
Mailing Address - Country:US
Mailing Address - Phone:804-745-9677
Mailing Address - Fax:804-745-8865
Practice Address - Street 1:1108 COURTHOUSE RD
Practice Address - Street 2:SUITE D
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3197
Practice Address - Country:US
Practice Address - Phone:804-745-9677
Practice Address - Fax:804-745-8865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9109811Medicaid
VA090379OtherANTHEM
0198880001Medicare ID - Type Unspecified