Provider Demographics
NPI:1740468099
Name:PROFESSIONAL RESPIRATORY CARE, LLC
Entity type:Organization
Organization Name:PROFESSIONAL RESPIRATORY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHIAT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:477-443-5013
Mailing Address - Street 1:2949 MARNAT RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2403
Mailing Address - Country:US
Mailing Address - Phone:443-501-3774
Mailing Address - Fax:
Practice Address - Street 1:2949 MARNAT RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2403
Practice Address - Country:US
Practice Address - Phone:443-501-3774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDW12349940332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies