Provider Demographics
NPI:1467566414
Name:LEADING RESPIRATORY SERVICES INC.
Entity Type:Organization
Organization Name:LEADING RESPIRATORY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:SANDLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-259-0199
Mailing Address - Street 1:111 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45690-1303
Mailing Address - Country:US
Mailing Address - Phone:740-941-3377
Mailing Address - Fax:740-941-0619
Practice Address - Street 1:111 E 2ND ST
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-1303
Practice Address - Country:US
Practice Address - Phone:740-941-3377
Practice Address - Fax:740-941-0619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH021035750332B00000X, 332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV6205030000Medicaid
KY90272097Medicaid
5239089OtherAETNA
OH2555784Medicaid
000000278277OtherANTHEM
OH000000278277OtherOHIO OPERATING ENGINEERS
OH000000278277OtherOHIO OPERATING ENGINEERS
5239089OtherAETNA