Provider Demographics
NPI:1932293065
Name:COPD RESPIRATORY SERVICES, LLC
Entity Type:Organization
Organization Name:COPD RESPIRATORY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCINROY
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:307-632-4147
Mailing Address - Street 1:600 E CARLSON ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-4271
Mailing Address - Country:US
Mailing Address - Phone:307-632-4147
Mailing Address - Fax:307-632-3321
Practice Address - Street 1:600 E CARLSON ST STE 101
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-4271
Practice Address - Country:US
Practice Address - Phone:307-632-4147
Practice Address - Fax:307-632-3321
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COPD RESPIRATORY SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-03
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1008704332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1253110001Medicare NSC