Provider Demographics
NPI:1114241940
Name:ALBANY PULMONARY AND CRITICAL CARE, P.C.
Entity Type:Organization
Organization Name:ALBANY PULMONARY AND CRITICAL CARE, P.C.
Other - Org Name:PULMONARY ASSOCIATES AND SLEEP APNEA CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PALAZZOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-438-5864
Mailing Address - Street 1:PO BOX 72105
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31708-2105
Mailing Address - Country:US
Mailing Address - Phone:229-438-5864
Mailing Address - Fax:
Practice Address - Street 1:214 E 4TH AVE
Practice Address - Street 2:
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015-3211
Practice Address - Country:US
Practice Address - Phone:229-438-5864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA037637207R00000X, 207RC0200X, 207RP1001X
GA143799207R00000X
GA043799207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACD9679OtherRR MEDICARE
GA2907OtherMEDICARE GROUP