Provider Demographics
NPI:1518262690
Name:SPECIAL RESPIRATORY CARE, INC
Entity Type:Organization
Organization Name:SPECIAL RESPIRATORY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:G
Authorized Official - Last Name:REITER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-717-8807
Mailing Address - Street 1:18327 NAPA ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-3617
Mailing Address - Country:US
Mailing Address - Phone:818-717-8807
Mailing Address - Fax:818-717-0910
Practice Address - Street 1:18327 NAPA ST
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-3617
Practice Address - Country:US
Practice Address - Phone:818-717-8807
Practice Address - Fax:818-717-0910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0430730001Medicare PIN