Healthcare Provider Details

I. General information

NPI: 1760165930
Provider Name (Legal Business Name): ADVANCED PULMONARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 MAIN ST UNIT B
MANCHESTER CT
06042-3541
US

IV. Provider business mailing address

175 MAIN ST UNIT B
MANCHESTER CT
06042-3541
US

V. Phone/Fax

Practice location:
  • Phone: 860-645-0145
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MILOS TOMIC
Title or Position: MEMBER
Credential: APRN
Phone: 860-645-0145