Healthcare Provider Details

I. General information

NPI: 1578736476
Provider Name (Legal Business Name): PULMONARY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2008
Last Update Date: 07/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 WEST MAIN STREET
ROMNEY WV
26757-0000
US

IV. Provider business mailing address

96 WEST MAIN STREET
ROMNEY WV
26757-0000
US

V. Phone/Fax

Practice location:
  • Phone: 304-822-8611
  • Fax: 304-822-8060
Mailing address:
  • Phone: 304-822-5417
  • Fax: 304-822-5236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number012590
License Number StateWV

VIII. Authorized Official

Name: MR. RONALD W COMBS
Title or Position: OWNER
Credential: RT
Phone: 304-257-3744