MEDICARE: SPIROCARE DME 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	332B00000X	Durable Medical Equipment & Medical Supplies	674	TN
2	332BX2000X	Oxygen Equipment & Supplies (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	674	OTHER	TN	STATE LICENSE

General Provider Information

NPI Number	:	1265434708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPIROCARE DME LLC

Provider Business Mailing Address
First Line	:	PO BOX 878
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38302-0878
Country	:	US
Telephone Number	:	731-660-0084
Fax Number	:	731-660-6215

Provider Business Practice Location Address
First Line	:	3325 ASPEN GROVE DR STE 104
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-2905
Country	:	US
Telephone Number	:	615-905-8808
Fax Number	:	615-823-3202

Authorized Official
Title or Position	:	CHIEF COMPLIANCE OFFICER
Name	:	MR. DANIEL BRETT STOUTE
Credential	:
Telephone Number	:	337-500-1977

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	05/17/2024

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Directions to “SPIROCARE DME LLC ” Practice Location

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