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General NPI Number Information
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NPI Number | 1003898875
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Entity Type | Organization
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Legal Business Name | PULMONARY ASSOCIATES INCORPORATED
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Dates
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Enumeration Date | 11/17/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 433 KEYSER AVE
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City | PETERSBURG
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State | WV
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Zip | 26847-9474
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Country | US
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Telephone | 304-257-9758
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Fax | 304-257-1774
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Provider Business Mailing Address
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Address Line | 96 WEST MAIN STREET
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City | ROMNEY
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State | WV
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Zip | 26757-1638
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Country | US
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Telephone | 304-822-5417
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Fax | 304-822-5236
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Authorized Official
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Title or Position | OWNER
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Name | MR. RONALD W COMBS
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Credential | RT
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Telephone | 304-257-3744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 002
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License Number State | WV
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