Healthcare Provider Details

I. General information

NPI: 1447525498
Provider Name (Legal Business Name): RESPIRATORY REVOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2012
Last Update Date: 03/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20761 24 MILE RD
MACOMB MI
48042-1914
US

IV. Provider business mailing address

20761 24 MILE RD
MACOMB MI
48042-1914
US

V. Phone/Fax

Practice location:
  • Phone: 800-451-0816
  • Fax: 586-408-6049
Mailing address:
  • Phone: 800-451-0816
  • Fax: 586-408-6049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. NICHOLAS GIOVANN EVOLA
Title or Position: PRESIDENT
Credential:
Phone: 586-738-2157