Provider Demographics
NPI:1194701698
Name:SPECIALTY RESPIRATORY SERVICES, LLC
Entity type:Organization
Organization Name:SPECIALTY RESPIRATORY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:STEFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:423-212-2129
Mailing Address - Street 1:10368 WALLACE ALLEY ST
Mailing Address - Street 2:SUITE7
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663-3977
Mailing Address - Country:US
Mailing Address - Phone:423-212-2129
Mailing Address - Fax:423-212-2139
Practice Address - Street 1:10368 WALLACE ALLEY ST
Practice Address - Street 2:SUITE7
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37663-3977
Practice Address - Country:US
Practice Address - Phone:423-212-2129
Practice Address - Fax:423-212-2139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-16
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001402332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1252560001Medicare NSC