Provider Demographics
NPI:1467439406
Name:PROFESSIONAL RESPIRATORY HOME CARE, INC.
Entity Type:Organization
Organization Name:PROFESSIONAL RESPIRATORY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-763-2688
Mailing Address - Street 1:1020 N PARROTT AVE
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-2110
Mailing Address - Country:US
Mailing Address - Phone:863-763-2688
Mailing Address - Fax:863-763-7896
Practice Address - Street 1:1020 N PARROTT AVE
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-2110
Practice Address - Country:US
Practice Address - Phone:863-763-2688
Practice Address - Fax:863-763-7896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-30
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
FL3202694332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR3171OtherBLUECROSS BLUESHIELD
FL028917500Medicaid
FL0272440001Medicare NSC