Provider Demographics
NPI:1063893485
Name:TOTAL RESPIRATORY AND REHAB INC.
Entity type:Organization
Organization Name:TOTAL RESPIRATORY AND REHAB INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER, AO
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-281-4443
Mailing Address - Street 1:5950 S 118TH CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-4426
Mailing Address - Country:US
Mailing Address - Phone:402-933-0400
Mailing Address - Fax:402-933-8400
Practice Address - Street 1:1355 SHERMAN RD STE 501
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-1208
Practice Address - Country:US
Practice Address - Phone:319-378-6939
Practice Address - Fax:319-378-6954
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOTAL RESPIRATORY AND REHAB INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-11
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA5763000006Medicare NSC