MEDICARE: PRO2 RESPIRATORY SERVICES, 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	332BX2000X	Oxygen Equipment & Supplies (DME)

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376578948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRO2 RESPIRATORY SERVICES, LLC

Provider Business Mailing Address
First Line	:	5800 CREEK RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-4010
Country	:	US
Telephone Number	:	513-469-7702
Fax Number	:	513-469-7707

Provider Business Practice Location Address
First Line	:	5800 CREEK RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-4010
Country	:	US
Telephone Number	:	513-469-7702
Fax Number	:	513-469-7707

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. NANCY ARCHDEACON
Credential	:	RRT
Telephone Number	:	513-469-7702

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	08/29/2012

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Directions to “PRO2 RESPIRATORY SERVICES, LLC ” Practice Location

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