MEDICARE: BEACON RESPIRATORY 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	332B00000X	Durable Medical Equipment & Medical Supplies	6880135741432	FL
2	332BX2000X	Oxygen Equipment & Supplies (DME)	324773	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144324245
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEACON RESPIRATORY SERVICES, INC.

Provider Business Mailing Address
First Line	:	555 E NORTH LN STE 5075
Second Line	:
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2490
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4757 E PRICE BLVD, UNITS 5 & 6
Second Line	:	UNIT 105
City	:	NORTH PORT
State	:	FL
Zip	:	34288-1829
Country	:	US
Telephone Number	:	941-423-4664
Fax Number	:	866-516-3747

Authorized Official
Title or Position	:	CCO
Name	:	WENDY RUSSALESI
Credential	:
Telephone Number	:	484-246-9499

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	10/12/2025

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