Healthcare Provider Details

I. General information

NPI: 1851381982
Provider Name (Legal Business Name): G3 HOME MEDICAL DBA RESPIRATORY SUPPORT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 COURTHOUSE SQ
BYRDSTOWN TN
38549-4351
US

IV. Provider business mailing address

30 COURTHOUSE SQ PO BOX 267
BYRDSTOWN TN
38549-4351
US

V. Phone/Fax

Practice location:
  • Phone: 931-864-7795
  • Fax: 931-864-6969
Mailing address:
  • Phone: 931-864-7795
  • Fax: 931-864-6969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0000000631
License Number StateTN

VIII. Authorized Official

Name: MRS. JAMIE ANNE GARRETT
Title or Position: CFO/PARTNER
Credential:
Phone: 931-864-7795