| Organization Name: | SOUTHERN RESPIRATORY, LLC |
| NPI Number: | 1437360799 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DETRA KAY PATE (OWNER) |
| Mailing Address: | 310 W Hill St Thomson |
| State: | GA US |
| Postal Code: | 308242113 |
| Phone Number: | 4042859683 |
| Fax Number: | |
| NPI Enumeration Date: | 05/25/2007 |
| NPI Last Update Date: | 02/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |