Provider Demographics
NPI:1508936667
Name:RESPIRATORY PLUS
Entity Type:Organization
Organization Name:RESPIRATORY PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:LANE
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-381-6766
Mailing Address - Street 1:PO BOX 1557
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38402-1557
Mailing Address - Country:US
Mailing Address - Phone:931-381-6766
Mailing Address - Fax:931-381-6988
Practice Address - Street 1:617 S JAMES CAMPBELL BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4392
Practice Address - Country:US
Practice Address - Phone:931-381-6766
Practice Address - Fax:931-381-6988
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:4476820001
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-08
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000693332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4048882OtherBCBSTN
10073590OtherAMERIGROUP
TN4582419Medicaid
TN0101OtherAMERICHOICE
TN4582419Medicaid