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General NPI Number Information
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NPI Number | 1932376027
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Entity Type | Organization
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Legal Business Name | PULMOHAB, LLC
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 575 LEXINGTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-1226
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Country | US
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Telephone | 973-390-3191
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Fax | 707-221-7688
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Provider Business Mailing Address
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Address Line | 575 LEXINGTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-1226
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Country | US
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Telephone | 973-390-3191
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Fax | 707-221-7688
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Authorized Official
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Title or Position | CEO
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Name | MR. JUAN JOSE RIVERA
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Credential | RRT
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Telephone | 973-390-3191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State | NJ
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Taxonomy #6
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State | NJ
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Taxonomy #7
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | NJ
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