Organization
LITTLE RIVER RESPIRATORY CARE, INC
Active
Other names
LITTLE RIVER MEDICAL EQUIPMENT
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY H FOX RRT (PRESIDENT)
(480) 325-8011
Entity
Organization
Contact information
Practice address
5540 E BROADWAY RD, SUITE 7, MESA, AZ 85206-1440
(480) 325-8011
(480) 325-7796
Mailing address
5540 E BROADWAY RD, SUITE 7, MESA, AZ 85206-1440
(480) 325-8011
(480) 325-7796
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
105930
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00200886
SALES TAX LICENSE
AZ
01
—
07-30169-M
BUS RETAIL LICENSE
AZ
01
—
105930
BOARD OF PHARM O2 LICENSE
AZ
05
—
551269
—
AZ
Enumeration date
08/03/2006
Last updated
08/22/2020
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