Provider Demographics
NPI:1295880904
Name:BEACON RESPIRATORY SERVICES, INC.
Entity type:Organization
Organization Name:BEACON RESPIRATORY SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTRACTING
Authorized Official - Prefix:
Authorized Official - First Name:ELLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-206-0040
Mailing Address - Street 1:26777 CENTRAL PARK BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-4162
Mailing Address - Country:US
Mailing Address - Phone:248-352-7530
Mailing Address - Fax:248-352-5189
Practice Address - Street 1:6550 SAINT AUGUSTINE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2835
Practice Address - Country:US
Practice Address - Phone:904-332-0656
Practice Address - Fax:904-332-9404
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARCADIA PRODUCTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-24
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies