Provider Demographics
NPI: | 1295350064 |
---|---|
Name: | SELECT RESPIRATORY SERVICES, LLC |
Entity type: | Organization |
Organization Name: | SELECT RESPIRATORY SERVICES, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | GREG |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CUNNINGHAM |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 916-350-0366 |
Mailing Address - Street 1: | 8836 GREENBACK LN STE H |
Mailing Address - Street 2: | |
Mailing Address - City: | ORANGEVALE |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 95662-4048 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 916-805-5119 |
Mailing Address - Fax: | 916-239-6530 |
Practice Address - Street 1: | 8836 GREENBACK LN STE H |
Practice Address - Street 2: | |
Practice Address - City: | ORANGEVALE |
Practice Address - State: | CA |
Practice Address - Zip Code: | 95662-4048 |
Practice Address - Country: | US |
Practice Address - Phone: | 916-805-5119 |
Practice Address - Fax: | 916-239-6530 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-06-08 |
Last Update Date: | 2020-06-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2279G1100X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | General Care | Group - Multi-Specialty |
No | 2279E1000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Educational | Group - Multi-Specialty |
No | 2279P1004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Pulmonary Diagnostics | Group - Multi-Specialty |
No | 2279P1005X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Pulmonary Rehabilitation | Group - Multi-Specialty |
No | 2279P1006X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Pulmonary Function Technologist | Group - Multi-Specialty |
No | 2279P3800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Palliative/Hospice | Group - Multi-Specialty |