Organization Active NPI

Southeastern Home Health Inc

Doing business as Rotech

  • Durable Medical Equipment & Medical Supplies
  • Douglas, GA
National Provider Identifier
1245291095
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SOUTHEASTERN HOME HEALTH INC
Doing business as
Rotech
Practice address
855 Bowens Mill Rd SW Ste C
Douglas, GA 31533-3925
Phone
(912) 383-6671
Fax
(912) 383-0500
NPI assigned
Mar 31, 2006
Organization subpart
Yes
Parent organization
ROTECH HEALTHCARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Robin L Menchen
Title
Chief Executive Officer
Phone
(407) 822-4600

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Customized Equipment (DME) 332BC3200X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Oxygen Equipment & Supplies (DME) 332BX2000X
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

855 Bowens Mill Rd SW Ste C
Douglas, GA 31533-3925

Mailing address

PO Box 27968
Salt Lake City, UT 84127-0968
Phone (570) 966-8030

Other identifiers 1

IdentifierTypeStateIssuer
000528503AMedicaidGA

Other names 1

  • ROTECH Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930092832 GA DME Supplier - Medical Supply CompanyDME Supplier - Oxygen & Equipment 9234259441 Practice locations: Douglas, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Southeastern Home Health Inc855 Bowens Mill Rd SW, Douglas, GA 31533-3925(912) 383-6671 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Gastric Suction Pumps|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|External Infusion Pumps and/or Supplies|Ins… Does not accept assignmentParticipating since Jan 1, 1995

National Provider Directory

National Provider Directory
Part of
Rotech Healthcare Inc

Locations

1200 Ocilla Rd
Douglas, GA 31533

855 Bowens Mill Rd SW
Ste C
Douglas, GA 31533
Phone (912) 383-6671

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1245291095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27968",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270968",
            "telephone_number": "570-966-8030",
            "fax_number": "570-966-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 BOWENS MILL RD SW STE C",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315333925",
            "telephone_number": "912-383-6671",
            "fax_number": "912-383-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN HOME HEALTH INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROTECH HEALTHCARE INC",
        "enumeration_date": "2006-03-31",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "MENCHEN",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "407-822-4600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000528503A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROTECH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Douglas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.