Provider Demographics
NPI:1740328079
Name:COMMUNITY RESPIRATORY CARE, INC.
Entity type:Organization
Organization Name:COMMUNITY RESPIRATORY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:915-626-8567
Mailing Address - Street 1:3465 LEE BLVD
Mailing Address - Street 2:SUITE 234
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-1473
Mailing Address - Country:US
Mailing Address - Phone:915-595-6461
Mailing Address - Fax:915-595-9901
Practice Address - Street 1:3465 LEE BLVD
Practice Address - Street 2:SUITE 234
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-1473
Practice Address - Country:US
Practice Address - Phone:915-595-6461
Practice Address - Fax:915-595-9901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170770502Medicaid
TX170770501Medicaid
TX170770502Medicaid