MEDICARE: PROFESSIONAL RESPIRATORY HOMECARE SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	R3307	MD

General Provider Information

NPI Number	:	1033462759
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL RESPIRATORY HOMECARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	11155 RED RUN BLVD STE 210
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-9500
Country	:	US
Telephone Number	:	410-281-0002
Fax Number	:	410-281-0009

Provider Business Practice Location Address
First Line	:	11155 RED RUN BLVD STE 210
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-9500
Country	:	US
Telephone Number	:	410-281-0002
Fax Number	:	410-281-0009

Authorized Official
Title or Position	:	CHIEF EXECUTIVE
Name	:	MR. ASMAMAW E. BEYENE
Credential	:	R.T.
Telephone Number	:	410-790-4899

Provider Enumeration Date	:	10/18/2012
Last Update Date	:	08/08/2024

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