Provider Demographics
NPI:1942579305
Name:THE RESPIRATORY & DIABETES CARE CENTER
Entity Type:Organization
Organization Name:THE RESPIRATORY & DIABETES CARE CENTER
Other - Org Name:THE RESPIRATORY & DIABETES CARE CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LONG
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CRT
Authorized Official - Phone:662-256-8686
Mailing Address - Street 1:1167 S GREEN ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-4900
Mailing Address - Country:US
Mailing Address - Phone:662-844-7772
Mailing Address - Fax:662-844-7762
Practice Address - Street 1:1113 HIGHWAY 278 E
Practice Address - Street 2:
Practice Address - City:AMORY
Practice Address - State:MS
Practice Address - Zip Code:38821-5627
Practice Address - Country:US
Practice Address - Phone:662-256-8686
Practice Address - Fax:662-256-8670
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE RESPIRATORY & DIABETES CARE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies