Provider Demographics
NPI:1912962879
Name:AIRCARE HOME RESPIRATORY LLC
Entity Type:Organization
Organization Name:AIRCARE HOME RESPIRATORY LLC
Other - Org Name:AIRCARE HOME RESPIRATORY, A VERUS HEALTHCARE COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-206-0040
Mailing Address - Street 1:1569 MALLORY LN BLDG 100
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2872
Mailing Address - Country:US
Mailing Address - Phone:800-487-5566
Mailing Address - Fax:
Practice Address - Street 1:13311 GARDEN GROVE BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843
Practice Address - Country:US
Practice Address - Phone:800-487-5566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VERUS HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-20
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102670332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03121FMedicaid
1319720001Medicare NSC