{"npi":"1124566716","type":"NPI-2","status":"active","name":{"display":"Beacon Respiratory Services Of Georgia, Inc.","other":[],"organization_name":"BEACON RESPIRATORY SERVICES OF GEORGIA, INC.","authorised_official":"Wendy Russalesi"},"specialty":{"primary_taxonomy":"332BX2000X","primary_taxonomy_description":"Oxygen Equipment & Supplies (DME)","slug":"oxygen-equipment-supplies-dme","schema_org_specialty":null,"all":[{"code":"332BX2000X","description":"Oxygen Equipment & Supplies (DME)","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"1023 W DEKALB ST","city":"CAMDEN","state":"SC","postal_code":"290204162","country_code":"US","phone":"8035724391","fax":"8037019115"},{"purpose":"MAILING","street_1":"555 E NORTH LN STE 5075","city":"CONSHOHOCKEN","state":"PA","postal_code":"194282490","country_code":"US"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"DE3787","state":"SC","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20170706000811","type_code":"30-54","type_desc":"DME SUPPLIER - MEDICAL SUPPLY COMPANY","state":"SC","pac_id":"9335351030"}]},"enumeration_date":"2017-02-03","last_updated":"2025-10-13","_meta":{"source":"NPPES","snapshot_date":"2025-10-13","doc_url":"https://findmynpi.com/api"}}