Healthcare Provider Details

I. General information

NPI: 1740328079
Provider Name (Legal Business Name): COMMUNITY RESPIRATORY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 02/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3465 LEE BLVD SUITE 234
EL PASO TX
79936-1473
US

IV. Provider business mailing address

3465 LEE BLVD SUITE 234
EL PASO TX
79936-1473
US

V. Phone/Fax

Practice location:
  • Phone: 915-595-6461
  • Fax: 915-595-9901
Mailing address:
  • Phone: 915-595-6461
  • Fax: 915-595-9901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JOHN RIVAS
Title or Position: PRESIDENT
Credential: RRT
Phone: 915-626-8567