Provider Demographics
NPI:1265434708
Name:SPIROCARE DME LLC
Entity type:Organization
Organization Name:SPIROCARE DME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:BRETT
Authorized Official - Last Name:STOUTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-500-1977
Mailing Address - Street 1:PO BOX 878
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38302-0878
Mailing Address - Country:US
Mailing Address - Phone:731-660-0084
Mailing Address - Fax:731-660-6215
Practice Address - Street 1:3325 ASPEN GROVE DR STE 104
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2905
Practice Address - Country:US
Practice Address - Phone:615-905-8808
Practice Address - Fax:615-823-3202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN674332B00000X
332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN674OtherSTATE LICENSE
TN674OtherSTATE LICENSE