Healthcare Provider Details

I. General information

NPI: 1720021868
Provider Name (Legal Business Name): PNEU-MED, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3475 E AMAZON
EUGENE OR
97405-0982
US

IV. Provider business mailing address

PO BOX 50490
EUGENE OR
97405-0982
US

V. Phone/Fax

Practice location:
  • Phone: 800-636-2704
  • Fax: 541-485-5529
Mailing address:
  • Phone: 800-636-2704
  • Fax: 541-485-5529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberNPC-0001897
License Number StateOR

VIII. Authorized Official

Name: MRS. STEPHANIE DIANE GLINES
Title or Position: BUSINESS MANAGER
Credential:
Phone: 800-636-2704