Provider Demographics
NPI:1356346977
Name:HOME RESPIRATORY SPECIALTIES LLC
Entity type:Organization
Organization Name:HOME RESPIRATORY SPECIALTIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:R
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:985-886-9599
Mailing Address - Street 1:82151 CHARLES KELLY RD
Mailing Address - Street 2:
Mailing Address - City:BUSH
Mailing Address - State:LA
Mailing Address - Zip Code:70431-4499
Mailing Address - Country:US
Mailing Address - Phone:985-886-9599
Mailing Address - Fax:504-324-0808
Practice Address - Street 1:82151 CHARLES KELLY RD
Practice Address - Street 2:
Practice Address - City:BUSH
Practice Address - State:LA
Practice Address - Zip Code:70431-4499
Practice Address - Country:US
Practice Address - Phone:985-886-9599
Practice Address - Fax:504-324-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1380644Medicaid
LA1380644Medicaid