Healthcare Provider Details

I. General information

NPI: 1972611671
Provider Name (Legal Business Name): HEALTH TOUCH RESPIRATORY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 SUNSET DRIVE STE J
GRENADA MS
38901
US

IV. Provider business mailing address

PO BOX 266
KILMICHAEL MS
39747
US

V. Phone/Fax

Practice location:
  • Phone: 662-227-2885
  • Fax: 662-227-2887
Mailing address:
  • Phone: 662-227-2885
  • Fax: 662-227-2887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. KEITH W WAKE
Title or Position: PRESIDENT
Credential:
Phone: 662-227-2885