Healthcare Provider Details

I. General information

NPI: 1285748236
Provider Name (Legal Business Name): LEADING RESPIRATORY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 11/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10679 US 23
LUCASVILLE OH
45648
US

IV. Provider business mailing address

PO BOX 255
MCDERMOTT OH
45652-0255
US

V. Phone/Fax

Practice location:
  • Phone: 740-259-0199
  • Fax: 740-259-1738
Mailing address:
  • Phone: 740-259-0199
  • Fax: 740-259-1738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number021035750
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number021035750
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number021035750
License Number StateOH

VIII. Authorized Official

Name: PHILLIP WAYNE SANDLIN
Title or Position: CEO PRESIDENT
Credential:
Phone: 740-259-0199