Provider Demographics
NPI:1558755371
Name:ADVANCED RESPIRATORY, INC.
Entity Type:Organization
Organization Name:ADVANCED RESPIRATORY, INC.
Other - Org Name:AMERICAN BIOSYSTEMS, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT FRONT LINE CARE (FLC)
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:O'CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-257-0042
Mailing Address - Street 1:1020 COUNTY ROAD F W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55126-2910
Mailing Address - Country:US
Mailing Address - Phone:800-426-4224
Mailing Address - Fax:800-870-8452
Practice Address - Street 1:5959 SHALLOWFORD RD STE 333
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2227
Practice Address - Country:US
Practice Address - Phone:423-825-4054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-19
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ021874Medicaid
TN1454361Medicaid
MN0828240001Medicare NSC
TN1454361Medicaid