Provider Demographics
NPI:1184742439
Name:IN HOME RESPIRATORY OF GA INC.
Entity type:Organization
Organization Name:IN HOME RESPIRATORY OF GA INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-772-9072
Mailing Address - Street 1:5490 MCGINNIS VILLAGE PLACE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-1733
Mailing Address - Country:US
Mailing Address - Phone:770-772-9072
Mailing Address - Fax:770-772-9073
Practice Address - Street 1:1455 ALDERMAN DR STE 200
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4160
Practice Address - Country:US
Practice Address - Phone:770-772-9072
Practice Address - Fax:770-772-9073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5629810001Medicare NSC