1285748236 NPI number — LEADING RESPIRATORY SERVICES INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285748236 NPI number — LEADING RESPIRATORY SERVICES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEADING RESPIRATORY SERVICES INC.
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:
1285748236
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 255
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCDERMOTT
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45652-0255
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-259-0199
Provider Business Mailing Address Fax Number:
740-259-1738

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10679 US 23
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUCASVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45648
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-259-0199
Provider Business Practice Location Address Fax Number:
740-259-1738
Provider Enumeration Date:
08/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SANDLIN
Authorized Official First Name:
PHILLIP
Authorized Official Middle Name:
WAYNE
Authorized Official Title or Position:
CEO PRESIDENT
Authorized Official Telephone Number:
740-259-0199

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  021035750 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X , with the licence number: 021035750 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 021035750 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000278277 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000278277 . This is a "OHIO OPERATING ENGINEERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6205030000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90272097 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5239089 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2555828 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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