Provider Demographics
NPI:1932286390
Name:RESPIRATORY CARE LLC
Entity Type:Organization
Organization Name:RESPIRATORY CARE LLC
Other - Org Name:SAVANNAH SLEEP DISORDER CTR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAKE
Authorized Official - Middle Name:WALKER
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-352-9049
Mailing Address - Street 1:340 EISENHOWER DR
Mailing Address - Street 2:BLDG. 1500
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-1600
Mailing Address - Country:US
Mailing Address - Phone:912-352-9049
Mailing Address - Fax:912-352-8985
Practice Address - Street 1:340 HODGSON CT
Practice Address - Street 2:STE 3
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-1520
Practice Address - Country:US
Practice Address - Phone:912-352-9049
Practice Address - Fax:912-352-8985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000526336EMedicaid
GA10057852OtherAMERIGROUP
GA374501OtherWELLCARE
GA47BBBKQMedicare PIN