Provider Demographics
NPI:1851381982
Name:G3 HOME MEDICAL DBA RESPIRATORY SUPPORT SERVICES
Entity Type:Organization
Organization Name:G3 HOME MEDICAL DBA RESPIRATORY SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-864-7795
Mailing Address - Street 1:30 COURTHOUSE SQ
Mailing Address - Street 2:PO BOX 267
Mailing Address - City:BYRDSTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38549-4351
Mailing Address - Country:US
Mailing Address - Phone:931-864-7795
Mailing Address - Fax:931-864-6969
Practice Address - Street 1:30 COURTHOUSE SQ
Practice Address - Street 2:
Practice Address - City:BYRDSTOWN
Practice Address - State:TN
Practice Address - Zip Code:38549-4351
Practice Address - Country:US
Practice Address - Phone:931-864-7795
Practice Address - Fax:931-864-6969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208000000X, 227800000X
TN0000000631332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4000002OtherBLUE CROSS BLUE SHIELD
TN1452525Medicaid
TN1452525Medicaid