Healthcare Provider Details

I. General information

NPI: 1093761611
Provider Name (Legal Business Name): PULMOCARE RESPIRATORY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25837 BUSINESS CENTER DR STE A
REDLANDS CA
92374-4514
US

IV. Provider business mailing address

PO BOX 990
LOMA LINDA CA
92354-0990
US

V. Phone/Fax

Practice location:
  • Phone: 909-777-5000
  • Fax: 909-777-5005
Mailing address:
  • Phone: 909-777-5000
  • Fax: 909-777-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License NumberGRT000030
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number100576
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number100576
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number100576
License Number StateCA

VIII. Authorized Official

Name: BRUCE ELLIOTT GINGLES
Title or Position: CEO
Credential:
Phone: 909-777-5000