Provider Demographics
NPI:1053704841
Name:TOTAL RESPIRATORY AND REHAB, INC.
Entity type:Organization
Organization Name:TOTAL RESPIRATORY AND REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-933-0400
Mailing Address - Street 1:5950 S 118TH CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-4426
Mailing Address - Country:US
Mailing Address - Phone:515-727-4923
Mailing Address - Fax:515-727-4932
Practice Address - Street 1:4178 NW URBANDALE DR
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-7915
Practice Address - Country:US
Practice Address - Phone:402-933-0400
Practice Address - Fax:402-933-8400
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOTAL RESPIRATORY AND REHAB, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-18
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA5763000003Medicare NSC