Basic Information
Provider Information
NPI: 1790258325
EntityType: 2
ReplacementNPI:  
OrganizationName: TWIN RIVERS RESPIRATORY CARE, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: AEROCARE
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 220 W GERMANTOWN PIKE STE 250
Address2:  
City: PLYMOUTH MEETING
State: PA
PostalCode: 194621437
CountryCode: US
TelephoneNumber: 6106306357
FaxNumber:  
Practice Location
Address1: 3286 W HILLSBORO ST UNIT A
Address2:  
City: EL DORADO
State: AR
PostalCode: 717306734
CountryCode: US
TelephoneNumber: 8704446550
FaxNumber: 8702006603
Other Information
ProviderEnumerationDate: 01/07/2019
LastUpdateDate: 11/04/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: GRIGGS
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName: P
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 4072060040
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: AEROCARE HOLDINGS LLC
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/04/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  N SuppliersDurable Medical Equipment & Medical Supplies 
332BX2000X  Y SuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies

No ID Information.


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