1427073246 NPI number — SENIOR RESPIRATORY SOLUTIONS, INC.

Table of content: (NPI 1427073246)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427073246 NPI number — SENIOR RESPIRATORY SOLUTIONS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SENIOR RESPIRATORY SOLUTIONS, 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:
6
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:
1427073246
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/07/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3101 KENNEDY LANE
Provider Second Line Business Mailing Address:
SUITE 1000
Provider Business Mailing Address City Name:
TEXARKANA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75503-3560
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-794-4386
Provider Business Mailing Address Fax Number:
903-794-4390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3101 KENNEDY LANE
Provider Second Line Business Practice Location Address:
SUITE 1000
Provider Business Practice Location Address City Name:
TEXARKANA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75503-3560
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-794-4386
Provider Business Practice Location Address Fax Number:
903-794-4390
Provider Enumeration Date:
07/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JACKSON
Authorized Official First Name:
LORI
Authorized Official Middle Name:
S
Authorized Official Title or Position:
CEO/BOARD OF DIRECTORS
Authorized Official Telephone Number:
903-794-4386

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  22407 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336M0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: 1000338 , 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: 1270547 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1427073246 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1427073246 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1427073246 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4613480 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 102559 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1427073246 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 149415716 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3810014223 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4826303 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 989890 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30765588 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4527668 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 584688200 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6031884 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: PH001TX , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 157363602 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200592340A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4153314 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4582406 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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