=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114468733
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INSPIRE RESPIRATORY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/15/2017
-----------------------------------------------------
Last Update Date | 03/15/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 900 ORCHID SPRINGS DR SUITE 100
-----------------------------------------------------
City | WINTER HAVEN
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33884-3656
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 863-513-5682
-----------------------------------------------------
Fax | 863-226-6284
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 900 ORCHID SPRINGS DR SUITE 100
-----------------------------------------------------
City | WINTER HAVEN
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33884-3656
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 863-513-5682
-----------------------------------------------------
Fax | 863-226-6284
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | GENERAL MANAGER
-----------------------------------------------------
Name | MR. JESSE SESSIONS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 863-513-5682
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------