Provider Demographics
NPI:1053866640
Name:C&OPD, LLC
Entity type:Organization
Organization Name:C&OPD, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOANNY
Authorized Official - Middle Name:EZEKIEL JAMES
Authorized Official - Last Name:DIAZ LUCIANO
Authorized Official - Suffix:
Authorized Official - Credentials:RCP RESPIRATORY CARE
Authorized Official - Phone:717-547-5407
Mailing Address - Street 1:4349 LINGLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-9196
Mailing Address - Country:US
Mailing Address - Phone:717-547-5407
Mailing Address - Fax:717-635-8347
Practice Address - Street 1:4349 LINGLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-9196
Practice Address - Country:US
Practice Address - Phone:717-547-5407
Practice Address - Fax:717-635-8347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 164W00000X, 227900000X, 2279E0002X, 251E00000X, 363L00000X
PAYM0146662278H0200X, 2278P1006X, 2279H0200X
PA9604697251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No2278H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedHome HealthGroup - Multi-Specialty
No2278P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary Function TechnologistGroup - Multi-Specialty
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Multi-Specialty
No2279E0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredEmergency CareGroup - Multi-Specialty
No2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome HealthGroup - Multi-Specialty
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty