Healthcare Provider Details

I. General information

NPI: 1861469959
Provider Name (Legal Business Name): HOME RESPIRATORY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 05/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417B EDWARDS RD
STARKE FL
32091-3903
US

IV. Provider business mailing address

417B EDWARDS RD
STARKE FL
32091-3903
US

V. Phone/Fax

Practice location:
  • Phone: 904-966-0520
  • Fax: 904-966-0521
Mailing address:
  • Phone: 904-966-0520
  • Fax: 904-966-0521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1434
License Number StateFL

VIII. Authorized Official

Name: MR. BRET J HINES
Title or Position: PRESIDENT
Credential: CRTT
Phone: 904-966-0520