Provider Demographics
NPI:1639334543
Name:SYMPHONY RESPIRATORY SERVICES
Entity Type:Organization
Organization Name:SYMPHONY RESPIRATORY SERVICES
Other - Org Name:GOLDEN CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCIAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KASICKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-325-7377
Mailing Address - Street 1:3500 FINANCIAL PLZ
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-3999
Mailing Address - Country:US
Mailing Address - Phone:866-325-7377
Mailing Address - Fax:866-412-7377
Practice Address - Street 1:711 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:BLACK RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54615-9108
Practice Address - Country:US
Practice Address - Phone:866-325-7377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERIDIAN HEALTHCARE GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41685700Medicaid
WI41685700Medicaid