Southern Home Respiratory Care, Inc.

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

01977 Issued in GA

Legal business name

SOUTHERN HOME RESPIRATORY CARE, INC.

Practice address

215 Sheraton Blvd Ste B
Macon, GA 31210-1359

Phone

(478) 757-0759

Fax

(478) 757-0769

NPI assigned

Jun 17, 2005

Organization subpart

Yes

Parent organization

SOUTHERN SLEEP TECHNOLOGIES INCAs reported in NPPES

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

Authorized official

Name

Mark Shane Mobley, RRT, PSGT

Title

Ceo

Phone

(478) 757-0759

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• SLEEP SERVICES OF AMERICA, INC Other name

Part of

Southern Sleep Technologies Inc

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Southern Sleep Technologies, Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Macon, GA
  • NPI 1225032261
  NPPES parent name

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224460800000",
    "number": "1740285543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SHERATON BLVD STE B",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101359",
            "telephone_number": "478-757-0759",
            "fax_number": "478-757-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 SHERATON BLVD STE B",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101359",
            "telephone_number": "478-757-0759",
            "fax_number": "478-757-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN HOME RESPIRATORY CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN SLEEP TECHNOLOGIES INC",
        "enumeration_date": "2005-06-17",
        "last_updated": "2008-10-20",
        "status": "A",
        "authorized_official_last_name": "MOBLEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "478-757-0759",
        "authorized_official_credential": "RRT, PSGT"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "GA",
            "license": "01977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR",
            "identifier": "310095300",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52008983001",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094619A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SLEEP SERVICES OF AMERICA, INC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Southern Home Care
• Southern Home Care Services, Inc.
• Southern Home Care Services, Inc.
• Southern Home Care Services, Inc.
• Southern Home Care Services, Inc.
• Southern Lung Specialists PC
• Southern Primary Care, LLC
• Southern Sleep Technologies, Inc
• Southerncare, Inc.
• Spa Medical LLC

• Customized Equipment (DME) in Macon, GA
• Providers in Macon, GA by specialty
• Customized Equipment (DME) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.