1316941743 NPI number — PANHANDLE RESPIRATORY RX, LTD

Table of content: (NPI 1316941743)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316941743 NPI number — PANHANDLE RESPIRATORY RX, LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PANHANDLE RESPIRATORY RX, LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316941743
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10003
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMARILLO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79116-0003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-353-2200
Provider Business Mailing Address Fax Number:
806-353-2291

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6700 W 9TH AVE
Provider Second Line Business Practice Location Address:
STE E
Provider Business Practice Location Address City Name:
AMARILLO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79106-1729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-353-2200
Provider Business Practice Location Address Fax Number:
806-353-2291
Provider Enumeration Date:
06/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BRITTEN
Authorized Official First Name:
STAN
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
806-353-2200

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  23079 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 130296407 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200351760 2 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00821785A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0377882 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 562045200 . This is a "FEDERAL BLACK LUNG PROGRA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1698748 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6085664701 , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 78176816 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 98004088 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100814980A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: DME00H91 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4581846 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5403116600 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0000776516 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".




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