Provider Demographics
NPI:1457342446
Name:RESPIRATORY HOME CARE OF VIRGINIA, INC
Entity Type:Organization
Organization Name:RESPIRATORY HOME CARE OF VIRGINIA, INC
Other - Org Name:VIRGINIA HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:INMAN II
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-873-1700
Mailing Address - Street 1:11842 CANON BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-2556
Mailing Address - Country:US
Mailing Address - Phone:757-873-1700
Mailing Address - Fax:757-873-0460
Practice Address - Street 1:11842 CANON BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2556
Practice Address - Country:US
Practice Address - Phone:757-873-1700
Practice Address - Fax:757-873-0460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0206008158332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01874OtherBOARD OF PHARMACY
VA033977OtherANTHEM BLUE CROSS
VA9132465Medicaid
VA9132465Medicaid
VA0466760001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER