MEDICARE: PULMOCARE RESPIRATORY SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	1291650001	CA

General Provider Information

NPI Number	:	1588054407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PULMOCARE RESPIRATORY SERVICES, INC.

Provider Business Mailing Address
First Line	:	760 VIA LATA AVE, SUITE 100
Second Line	:
City	:	COLTON
State	:	CA
Zip	:	92324
Country	:	US
Telephone Number	:	909-777-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3538 N ROMERO RD STE 160
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-5278
Country	:	US
Telephone Number	:	888-785-6622
Fax Number	:	888-785-8666

Authorized Official
Title or Position	:	CEO
Name	:	MR. BRUCE E GINGLES
Credential	:
Telephone Number	:	909-777-5000

Provider Enumeration Date	:	01/30/2015
Last Update Date	:	01/30/2015

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