Organization
NORTH CENTRAL RESPIRATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK A. DELAUTER N/A (PRESIDENT/CO-OWNER)
(866) 569-9891
Entity
Organization
Contact information
Practice address
595 MANCHESTER AVE, WABASH, IN 46992-1414
(866) 569-9891
(260) 569-9841
Mailing address
595 MANCHESTER AVE, WABASH, IN 46992-1414
(866) 569-9891
(260) 569-9841
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000233614
ANTHEM BC/BS
IN
Enumeration date
08/24/2005
Last updated
08/22/2020
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