=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316941743
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PANHANDLE RESPIRATORY RX, LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/13/2005
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6700 W 9TH AVE STE E
-----------------------------------------------------
City | AMARILLO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79106-1729
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-353-2200
-----------------------------------------------------
Fax | 806-353-2291
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 10003
-----------------------------------------------------
City | AMARILLO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79116-0003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-353-2200
-----------------------------------------------------
Fax | 806-353-2291
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING PARTNER
-----------------------------------------------------
Name | MR. STAN BRITTEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 806-353-2200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 23079
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------