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General NPI Number Information
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NPI Number | 1215157086
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Entity Type | Organization
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Legal Business Name | TRI COUNTY COUNTY RESPIRATORY CARE LLC
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 160 SW 12TH AVE # 107
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-3119
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Country | US
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Telephone | 954-421-8385
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Fax |
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Provider Business Mailing Address
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Address Line | 160 SW 12TH AVENUE # 107
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441
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Country | US
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Telephone | 954-421-8385
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ANDREW V COHEN
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Credential |
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Telephone | 954-421-8385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 326518
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License Number State | FL
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