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General NPI Number Information
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NPI Number | 1104821404
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Entity Type | Organization
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Legal Business Name | NEW AGE PULMONARY SERVICES LLC
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 10/14/2022
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Provider Practice Location Address
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Address Line | 3040 BRECKENRIDGE LN
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City | LOUISVILLE
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State | KY
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Zip | 40220-2194
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Country | US
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Telephone | 502-458-6277
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Fax | 502-458-6858
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Provider Business Mailing Address
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Address Line | 3040 BRECKENRIDGE LN
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City | LOUISVILLE
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State | KY
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Zip | 40220-2194
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Country | US
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Telephone | 502-458-6277
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Fax | 502-458-6858
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. TERRI L LIMBAUGH
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Credential | CRT
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Telephone | 502-458-6277
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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 | 145375
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License Number State | KY
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