Organization
PORTABLE HOME RESPIRATORY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EDITH E SELBY (OWNER OFFICER)
(800) 768-0336
Entity
Organization
Contact information
Practice address
4990 SW 52ND STREET, SUITE 211, FT LAUDERDALE, FL 33314-5520
(800) 768-0336
(954) 452-7774
Mailing address
4990 SW 52ND STREET, SUITE 211, FT LAUDERDALE, FL 33314-5520
(800) 768-0336
(954) 452-7774
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3300368
FL
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
591
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R6339
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/23/2007
Last updated
12/12/2007
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