Provider Demographics
NPI:1639105091
Name:BRADEN PARTNERS LP
Entity Type:Organization
Organization Name:BRADEN PARTNERS LP
Other - Org Name:PACIFIC PULMONARY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-893-1518
Mailing Address - Street 1:8730 HARRIS RD
Mailing Address - Street 2:UNIT 204
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-8990
Mailing Address - Country:US
Mailing Address - Phone:661-396-3720
Mailing Address - Fax:661-832-6009
Practice Address - Street 1:1830 W 64TH LN
Practice Address - Street 2:SUITE A
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-2355
Practice Address - Country:US
Practice Address - Phone:303-432-0202
Practice Address - Fax:303-432-1592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO02882876Medicaid
CO02882876Medicaid