Healthcare Provider Details

I. General information

NPI: 1265434708
Provider Name (Legal Business Name): SPIROCARE DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 ASPEN GROVE DR STE 104
FRANKLIN TN
37067-2905
US

IV. Provider business mailing address

PO BOX 878
JACKSON TN
38302-0878
US

V. Phone/Fax

Practice location:
  • Phone: 615-905-8808
  • Fax: 615-823-3202
Mailing address:
  • Phone: 731-660-0084
  • Fax: 731-660-6215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number674
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL BRETT STOUTE
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 337-500-1977