Evanko Respiratory, Inc

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

8000000940 Issued in PA

Legal business name

EVANKO RESPIRATORY, INC

Practice address

321 Berner Ave
Hazleton, PA 18201-7472

Phone

(570) 455-4699

Fax

(570) 455-3296

NPI assigned

Jul 8, 2006

Organization subpart

Yes

Parent organization

DYNAMIC HEALTHCARE SERVICES INC.As reported in NPPES

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

Authorized official

Name

Mr. Michael John Grabko

Title

Ceo

Phone

(717) 657-2100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dynamic Healthcare Services PA Doing business as

Locations

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466726400000",
    "number": "1891728341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 SARHELM RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171123339",
            "telephone_number": "717-657-2100",
            "fax_number": "717-657-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 BERNER AVE",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182017472",
            "telephone_number": "570-455-4699",
            "fax_number": "570-455-3296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANKO RESPIRATORY, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DYNAMIC HEALTHCARE SERVICES INC.",
        "enumeration_date": "2006-07-08",
        "last_updated": "2016-06-24",
        "status": "A",
        "authorized_official_last_name": "GRABKO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "717-657-2100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "PA",
            "license": "8000000940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018612920004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic Healthcare Services PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oxygen Equipment & Supplies (DME) in Hazleton, PA
• Providers in Hazleton, PA by specialty
• Oxygen Equipment & Supplies (DME) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; 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.