Provider Demographics
NPI:1356394381
Name:RESPIRATORY DIAGNOSTICS LLC
Entity type:Organization
Organization Name:RESPIRATORY DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALPHIN
Authorized Official - Suffix:
Authorized Official - Credentials:RRT RCP
Authorized Official - Phone:803-786-1588
Mailing Address - Street 1:168 COLUMBIA CLUB DR W
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-9458
Mailing Address - Country:US
Mailing Address - Phone:803-786-1588
Mailing Address - Fax:888-817-0201
Practice Address - Street 1:168 COLUMBIA CLUB DR W
Practice Address - Street 2:
Practice Address - City:BLYTHEWOOD
Practice Address - State:SC
Practice Address - Zip Code:29016-9458
Practice Address - Country:US
Practice Address - Phone:803-786-1588
Practice Address - Fax:888-817-0201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC291U00000X
SC42D1050919293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY72100159780Medicaid
CA1396354381Medicaid
SCL00246Medicaid
OH0060691Medicaid
MO1356394381Medicaid
NC7001448Medicaid
TN1527148Medicaid
OK200405170AMedicaid
KS200750640AMedicaid
SCP00813310OtherRAILROAD MEDICARE
VAVAMedicaid
NE10026155100Medicaid
MO1356394381Medicaid