Organization
VISITING RESPIRATORY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL B KOEHN (ACCOUNTS MANAGER)
(919) 320-6243
Entity
Organization
Contact information
Practice address
606 35TH AVE N APT B, MYRTLE BEACH, SC 29577-1303
(919) 235-2949
(888) 803-0047
Mailing address
606 35TH AVE N APT B, MYRTLE BEACH, SC 29577-1303
(919) 235-2949
(888) 803-0047
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
A-2946
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016W0
BCBS GROUP#
NC
01
—
1386Y
BCBS INDIVIDUAL PI
NC
05
—
7211265
—
NC
05
—
7492633
—
NC
Enumeration date
09/25/2006
Last updated
03/17/2018
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