Provider Demographics
NPI:1194720292
Name:NEW HOME RESPIRATORY CARE, INC
Entity type:Organization
Organization Name:NEW HOME RESPIRATORY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:CRT
Authorized Official - Phone:708-547-6020
Mailing Address - Street 1:5813 SAINT CHARLES RD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:IL
Mailing Address - Zip Code:60163-1031
Mailing Address - Country:US
Mailing Address - Phone:708-547-6020
Mailing Address - Fax:708-547-6025
Practice Address - Street 1:5813 SAINT CHARLES RD
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:IL
Practice Address - Zip Code:60163-1031
Practice Address - Country:US
Practice Address - Phone:708-547-6020
Practice Address - Fax:708-547-6025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203-000640332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL=========001Medicaid