Provider Demographics
NPI:1992092621
Name:MEDICAL AND RESPIRATORY SERVICES
Entity type:Organization
Organization Name:MEDICAL AND RESPIRATORY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:BURDETT
Authorized Official - Last Name:VORDTRIEDE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:850-533-6266
Mailing Address - Street 1:922 MAR WALT DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FT. WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32457
Mailing Address - Country:US
Mailing Address - Phone:850-862-6277
Mailing Address - Fax:850-862-6279
Practice Address - Street 1:922 MAR WALT DR
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-6630
Practice Address - Country:US
Practice Address - Phone:850-862-6277
Practice Address - Fax:850-862-6279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies