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NPI Code Detail

MEDICARE: BEACON RESPIRATORY SERVICES, INC.

MEDICARE: BEACON RESPIRATORY SERVICES, INC.
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
1332B00000XDurable Medical Equipment & Medical Supplies3880135741464FL
2332BX2000XOxygen Equipment & Supplies (DME)3204779FL

Other Identifiers

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

General Provider Information

NPI Number : 1174628515
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEACON RESPIRATORY SERVICES, INC.
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 : 5805 N HIGHWAY 27
Second Line :
City : SEBRING
State : FL
Zip : 33870-1216
Country : US
Telephone Number : 863-382-8464
Fax Number : 863-382-8979
Authorized Official
Title or Position : CHIEF COMPLIANCE OFFICER
Name : WENDY RUSSALESI
Credential :
Telephone Number : 484-246-9499
Provider Enumeration Date : 09/13/2006
Last Update Date : 12/17/2025

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Directions to “BEACON RESPIRATORY SERVICES, INC. ” Practice Location

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