Organization
AT HOME RESPIRATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OTTO KEITH BOYETT (PRESIDENT)
(904) 733-8445
Entity
Organization
Contact information
Practice address
8081 PHILIPS HWY, SUITE 15, JACKSONVILLE, FL 32256-7464
(904) 733-8445
(904) 733-8446
Mailing address
8081 PHILIPS HWY, SUITE 15, JACKSONVILLE, FL 32256-7464
(904) 733-8445
(904) 733-8446
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026498900
—
FL
01
—
R9520
BCBS PARTICIPATING PROVIDER
FL
Enumeration date
05/04/2006
Last updated
04/15/2011
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