Provider Demographics
NPI:1215157086
Name:TRI COUNTY COUNTY RESPIRATORY CARE LLC
Entity type:Organization
Organization Name:TRI COUNTY COUNTY RESPIRATORY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:V
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-421-8385
Mailing Address - Street 1:160 SW 12TH AVENUE
Mailing Address - Street 2:# 107
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441
Mailing Address - Country:US
Mailing Address - Phone:954-421-8385
Mailing Address - Fax:
Practice Address - Street 1:160 SW 12TH AVE
Practice Address - Street 2:# 107
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-3119
Practice Address - Country:US
Practice Address - Phone:954-421-8385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL326518332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL326518OtherSTATE OF FLORIDA OXYGEN R