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General NPI Number Information
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NPI Number | 1790903268
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Entity Type | Organization
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Legal Business Name | PORTABLE HOME RESPIRATORY INC
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 4990 SW 52ND STREET SUITE 211
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City | FT LAUDERDALE
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State | FL
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Zip | 33314-5520
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Country | US
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Telephone | 800-768-0336
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Fax | 954-452-7774
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Provider Business Mailing Address
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Address Line | 4990 SW 52ND STREET SUITE 211
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City | FT LAUDERDALE
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State | FL
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Zip | 33314-5520
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Country | US
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Telephone | 800-768-0336
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Fax | 954-452-7774
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Authorized Official
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Title or Position | OWNER OFFICER
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Name | MS. EDITH E SELBY
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Credential |
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Telephone | 800-768-0336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 3300368
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 591
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License Number State | FL
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