Healthcare Provider Details

I. General information

NPI: 1942209705
Provider Name (Legal Business Name): RESPIRATORY THERAPY ASSOCIATES OF PA, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 12/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 WILMINGTON W CHESTER PIKE SUITE 2
CHADDS FORD PA
19317-9039
US

IV. Provider business mailing address

521 PROGRESS DR SUITE A-C
LINTHICUM MD
21090-2241
US

V. Phone/Fax

Practice location:
  • Phone: 610-558-6222
  • Fax: 610-558-6226
Mailing address:
  • Phone: 443-200-0055
  • Fax: 443-200-0054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number6000003660
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0002572000
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHMO INDEPENDENCE B/C
# 2
Identifier0000396816
Identifier TypeMEDICAID
Identifier StateDE
Identifier Issuer
# 3
Identifier540719
Identifier TypeOTHER
Identifier State
Identifier IssuerAETNA HMO
# 4
Identifier219792
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerPA BLUE SHIELD

VIII. Authorized Official

Name: MS. YOLANDA M MARTINEZ
Title or Position: CEO
Credential:
Phone: 443-200-0055