Healthcare Provider Details

I. General information

NPI: 1215230594
Provider Name (Legal Business Name): AEROCARE HOLDINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2010
Last Update Date: 06/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5005 PROSPECT AVE NE STE B
ALBUQUERQUE NM
87110
US

IV. Provider business mailing address

3325 BARTLETT BLVD
ORLANDO FL
32811-6428
US

V. Phone/Fax

Practice location:
  • Phone: 505-955-8552
  • Fax: 505-982-4565
Mailing address:
  • Phone: 407-206-0040
  • Fax: 407-206-0010

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: STEPHEN P GRIGGS
Title or Position: CEO
Credential:
Phone: 407-206-0040