Provider Demographics
NPI:1356500136
Name:RESPIRATORY CARE EXTENDED SERVICES, INC.
Entity type:Organization
Organization Name:RESPIRATORY CARE EXTENDED SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RRT
Authorized Official - Prefix:MR
Authorized Official - First Name:HOSEA
Authorized Official - Middle Name:JEFFERY
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:786-367-0635
Mailing Address - Street 1:5522 BARNSTEAD CIRCLE
Mailing Address - Street 2:STE. 03
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6617
Mailing Address - Country:US
Mailing Address - Phone:786-367-0635
Mailing Address - Fax:561-370-6382
Practice Address - Street 1:5522 BARNSTEAD CIRCLE
Practice Address - Street 2:STE. 03
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-6617
Practice Address - Country:US
Practice Address - Phone:786-367-0635
Practice Address - Fax:561-370-6382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Multi-Specialty
No227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL885761000Medicaid