MEDICARE: LEE'S RESPIRATORY SERVICES

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	0521177	NV

General Provider Information

NPI Number	:	1437134715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEE'S RESPIRATORY SERVICES

Provider Business Mailing Address
First Line	:	200 BATH ST
Second Line	:	SUITE 2
City	:	CARSON CITY
State	:	NV
Zip	:	89703-2459
Country	:	US
Telephone Number	:	775-883-8600
Fax Number	:	775-883-8660

Provider Business Practice Location Address
First Line	:	200 BATH ST
Second Line	:	SUITE 2
City	:	CARSON CITY
State	:	NV
Zip	:	89703-2405
Country	:	US
Telephone Number	:	775-883-8600
Fax Number	:	775-883-8660

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. JODY LYNN WAKAMASTU
Credential	:
Telephone Number	:	775-883-8600

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	08/22/2020

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