| Organization Name: | BEACON RESPIRATORY SERVICES OF GEORGIA INC. |
| NPI Number: | 1629373527 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHEN P. GRIGGS (CEO) |
| Mailing Address: | 1030 Juniper Lake Rd Ste G And H West End |
| State: | NC US |
| Postal Code: | 273768897 |
| Phone Number: | 9102150950 |
| Fax Number: | 9102150940 |
| NPI Enumeration Date: | 01/24/2011 |
| NPI Last Update Date: | 11/07/2011 |
| 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: | |