Healthcare Provider Details

I. General information

NPI: 1427143114
Provider Name (Legal Business Name): PULMONARY & CRITICAL CARE ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 SMITH AVE N SUITE 300
SAINT PAUL MN
55102-2534
US

IV. Provider business mailing address

225 SMITH AVE N SUITE 300
SAINT PAUL MN
55102-2534
US

V. Phone/Fax

Practice location:
  • Phone: 651-726-6200
  • Fax: 651-726-6201
Mailing address:
  • Phone: 651-726-6200
  • Fax: 651-726-6201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: TOM G LORENTZEN
Title or Position: CEO
Credential:
Phone: 651-726-6200