=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548957970
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INFINITE RESPIRATORY SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2023
-----------------------------------------------------
Last Update Date | 04/18/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5614 N FRESNO ST STE 111
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93710-6034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-860-0423
-----------------------------------------------------
Fax | 559-869-4642
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5614 N FRESNO ST STE 111
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93710-6034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-860-0423
-----------------------------------------------------
Fax | 559-869-4642
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | PATRICK MILLER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 619-763-3069
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------