Provider Demographics
NPI:1548336076
Name:HOME RESPIRATORY INC
Entity type:Organization
Organization Name:HOME RESPIRATORY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:BERRYHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-542-2727
Mailing Address - Street 1:13777 BALLANTYNE CORPORATE PL
Mailing Address - Street 2:STE 335
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-3419
Mailing Address - Country:US
Mailing Address - Phone:704-542-2727
Mailing Address - Fax:704-542-5121
Practice Address - Street 1:13777 BALLANTYNE CORPORATE PL
Practice Address - Street 2:STE 335
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3419
Practice Address - Country:US
Practice Address - Phone:704-542-2727
Practice Address - Fax:704-542-5121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01263332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704705Medicaid
NC7704705Medicaid