Provider Demographics
NPI:1992808190
Name:MARIAN RESPIRATORY CARE, INC.
Entity type:Organization
Organization Name:MARIAN RESPIRATORY CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOND
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:888-530-8088
Mailing Address - Street 1:28691 US HIGHWAY 98 STE D1
Mailing Address - Street 2:SUITE D1
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-7196
Mailing Address - Country:US
Mailing Address - Phone:251-473-2222
Mailing Address - Fax:251-473-1064
Practice Address - Street 1:28691 US HIGHWAY 98
Practice Address - Street 2:STE. D1
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-7195
Practice Address - Country:US
Practice Address - Phone:251-473-2222
Practice Address - Fax:251-473-1064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009923210Medicaid
AL100003699Medicaid
AL51045831OtherBCBS ALABAMA PROVIDER NUM
AL=========OtherAETNA PROVIDER NUMBER
AL=========OtherTRICARE PROV ID
AL100003699Medicaid
AL009923210Medicaid
AL100003699Medicaid