Healthcare Provider Details

I. General information

NPI: 1457342446
Provider Name (Legal Business Name): RESPIRATORY HOME CARE OF VIRGINIA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11842 CANON BLVD
NEWPORT NEWS VA
23606-2556
US

IV. Provider business mailing address

11842 CANON BLVD
NEWPORT NEWS VA
23606-2556
US

V. Phone/Fax

Practice location:
  • Phone: 757-873-1700
  • Fax: 757-873-0460
Mailing address:
  • Phone: 757-873-1700
  • Fax: 757-873-0460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number0206008158
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number0206008158
License Number StateVA

VIII. Authorized Official

Name: MR. THOMAS E. INMAN II
Title or Position: PRESIDENT
Credential:
Phone: 757-873-1700