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General NPI Number Information
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NPI Number | 1710934757
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Entity Type | Organization
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Legal Business Name | PEGASUS AIRWAVE INC.
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 11/05/2008
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Provider Practice Location Address
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Address Line | 1180 S.W. 36TH AVE. SUITE 103
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City | POMPANO BEACH
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State | FL
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Zip | 33069
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Country | US
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Telephone | 954-975-6808
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Fax | 954-252-4210
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Provider Business Mailing Address
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Address Line | 1180 S.W. 36TH AVE. SUITE 103
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City | POMPANO BEACH
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State | FL
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Zip | 33069
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Country | US
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Telephone | 954-975-6808
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Fax | 954-252-4210
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MRS. LORRIE A FRENCH
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Credential |
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Telephone | 954-975-6808
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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 | 1277
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License Number State | FL
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