MEDICARE: RESP-A-SURE, 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	2278E1000X	Educational Certified Respiratory Therapist	26804	CA
2	2278G0305X	Geriatric Care Certified Respiratory Therapist	26804	CA
3	2278G1100X	General Care Certified Respiratory Therapist	26804	CA
4	2278H0200X	Home Health Certified Respiratory Therapist	26804	CA
5	2278P1005X	Pulmonary Rehabilitation Certified Respiratory Therapist	26804	CA
6	227800000X	Certified Respiratory Therapist	26804	CA

General Provider Information

NPI Number	:	1962880013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESP-A-SURE, INC.

Provider Business Mailing Address
First Line	:	3200 E GUASTI RD
Second Line	:	SUITE NUMBER 100
City	:	ONTARIO
State	:	CA
Zip	:	91761-8660
Country	:	US
Telephone Number	:	909-821-5111
Fax Number	:	909-986-2545

Provider Business Practice Location Address
First Line	:	3200 E GUASTI RD
Second Line	:	SUITE NUMBER 100
City	:	ONTARIO
State	:	CA
Zip	:	91761-8660
Country	:	US
Telephone Number	:	909-821-5111
Fax Number	:	909-986-2545

Authorized Official
Title or Position	:	PRESIDENT /CEO
Name	:	MR. BURNEY BERNARD IRVIN IV
Credential	:	RCP
Telephone Number	:	909-821-5111

Provider Enumeration Date	:	05/08/2015
Last Update Date	:	05/11/2015

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Directions to “RESP-A-SURE, INC. ” Practice Location

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