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NPI Code Detail

MEDICARE: PULMOCARE RESPIRATORY SERVICES, INC.

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
1332BX2000XOxygen Equipment & Supplies (DME)MP00661/MP00837NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11093761611OTHERCAMEDICARE NPI

General Provider Information

NPI Number : 1801168018
Entity Type Code : Organization
Provider Name (Legal Business Name) : PULMOCARE RESPIRATORY SERVICES, INC.
Provider Business Mailing Address
First Line : PO BOX 721
Second Line :
City : COLTON
State : CA
Zip : 92324-0721
Country : US
Telephone Number : 888-785-6622
Fax Number :
Provider Business Practice Location Address
First Line : 2675 E PATRICK LN STE 11
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-2437
Country : US
Telephone Number : 888-785-6622
Fax Number :
Authorized Official
Title or Position : CEO
Name : MR. BRUCE E GINGLES
Credential :
Telephone Number : 888-785-6622
Provider Enumeration Date : 02/02/2012
Last Update Date : 05/05/2020

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