Healthcare Provider Details

I. General information

NPI: 1902053317
Provider Name (Legal Business Name): PULMONOSTICS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2008
Last Update Date: 08/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6234 OLD RANGELINE RD
THEODORE AL
36582-5244
US

IV. Provider business mailing address

6234 OLD RANGELINE RD
THEODORE AL
36582-5244
US

V. Phone/Fax

Practice location:
  • Phone: 251-581-4721
  • Fax:
Mailing address:
  • Phone: 251-581-4721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279P1004X
TaxonomyPulmonary Diagnostics Registered Respiratory Therapist
License Number2262
License Number StateAL

VIII. Authorized Official

Name: DANIEL S COOK
Title or Position: PRESIDENT
Credential: RRT
Phone: 251-581-4721