Provider Demographics
NPI:1801028634
Name:MEDICAL WEST RESPIRATORY CENTRAL, LLC
Entity Type:Organization
Organization Name:MEDICAL WEST RESPIRATORY CENTRAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:LANE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:314-993-7900
Mailing Address - Street 1:9301 DIELMAN INDUSTRIAL D
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-2204
Mailing Address - Country:US
Mailing Address - Phone:314-993-8100
Mailing Address - Fax:314-993-8101
Practice Address - Street 1:15502 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1350
Practice Address - Country:US
Practice Address - Phone:913-888-2500
Practice Address - Fax:913-888-2503
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL WEST RESPIRATORY SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-12
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS6304380001Medicare NSC