MEDICARE: RESPIRATORY SPECIALISTS OF INDIANA, 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
1	332B00000X	Durable Medical Equipment & Medical Supplies		IN

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

General Provider Information

NPI Number	:	1518951409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESPIRATORY SPECIALISTS OF INDIANA, INC.

Provider Business Mailing Address
First Line	:	1715 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-2733
Country	:	US
Telephone Number	:	317-351-2050
Fax Number	:

Provider Business Practice Location Address
First Line	:	1715 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-2733
Country	:	US
Telephone Number	:	317-351-2050
Fax Number	:	317-351-1120

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RON A YOUNG
Credential	:
Telephone Number	:	317-786-5425

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	06/21/2018

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