Provider Demographics
NPI:1770800617
Name:SNF RESPIRATORY CARE, LLC
Entity type:Organization
Organization Name:SNF RESPIRATORY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/RESPIRATORY CARE PRACTICIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-323-7055
Mailing Address - Street 1:W2803 IVY LN
Mailing Address - Street 2:
Mailing Address - City:PORTERFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54159-9602
Mailing Address - Country:US
Mailing Address - Phone:920-323-7055
Mailing Address - Fax:
Practice Address - Street 1:W2803 IVY LN
Practice Address - Street 2:
Practice Address - City:PORTERFIELD
Practice Address - State:WI
Practice Address - Zip Code:54159-9602
Practice Address - Country:US
Practice Address - Phone:920-323-7055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI532028332B00000X
WI532-028227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty