MEDICARE: RESPIRATORY HOME CARE OF BRISTOL, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier
2	332BX2000X	Oxygen Equipment & Supplies (DME)	869	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033195110
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESPIRATORY HOME CARE OF BRISTOL, LLC

Provider Business Mailing Address
First Line	:	555 E NORTH LN STE 5075
Second Line	:
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2490
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 RIVERSIDE DR STE 340
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37406
Country	:	US
Telephone Number	:	423-386-1126
Fax Number	:	423-386-1161

Authorized Official
Title or Position	:	CCO
Name	:	WENDY RUSSALESI
Credential	:
Telephone Number	:	484-246-9499

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	10/14/2025

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