Provider Demographics
NPI:1386801553
Name:SHAMROCK RESPIRATORY SERVICES LLC
Entity type:Organization
Organization Name:SHAMROCK RESPIRATORY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMMELLEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-996-4319
Mailing Address - Street 1:905 W EISENHOWER CIR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6400
Mailing Address - Country:US
Mailing Address - Phone:888-996-4319
Mailing Address - Fax:877-204-0094
Practice Address - Street 1:905 W EISENHOWER CIR
Practice Address - Street 2:SUITE 102
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-6400
Practice Address - Country:US
Practice Address - Phone:888-996-4319
Practice Address - Fax:877-204-0094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6153810001Medicare NSC
OH6153810001Medicare NSC
IN6153810001Medicare NSC