Provider Demographics
NPI:1821392226
Name:TOTAL RESPIRATORY CARE INC.
Entity Type:Organization
Organization Name:TOTAL RESPIRATORY CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KORY
Authorized Official - Middle Name:S
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-298-8831
Mailing Address - Street 1:1395 N 400 E
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-7530
Mailing Address - Country:US
Mailing Address - Phone:801-298-8831
Mailing Address - Fax:801-298-2549
Practice Address - Street 1:670 S HIGHWAY 89A
Practice Address - Street 2:SUITE 1
Practice Address - City:KANAB
Practice Address - State:UT
Practice Address - Zip Code:84741
Practice Address - Country:US
Practice Address - Phone:435-644-5100
Practice Address - Fax:435-644-5131
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOTAL RESPIRATORY CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-29
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========005Medicaid
UT1112420001Medicare NSC