Provider Demographics
NPI:1942300108
Name:VISITING RESPIRATORY CARE
Entity Type:Organization
Organization Name:VISITING RESPIRATORY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:KOEHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-320-6243
Mailing Address - Street 1:606 35TH AVE N APT B
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-1303
Mailing Address - Country:US
Mailing Address - Phone:919-235-2949
Mailing Address - Fax:888-803-0047
Practice Address - Street 1:606 35TH AVE N APT B
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-1303
Practice Address - Country:US
Practice Address - Phone:919-235-2949
Practice Address - Fax:888-803-0047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA-2946227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC016W0OtherBCBS GROUP#
NC7211265Medicaid
NC7492633Medicaid
NC1386YOtherBCBS INDIVIDUAL PI