Provider Demographics
NPI:1750494084
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:YEHOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARNES
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 1:3384 N PUBLISHERS DR
Practice Address - Street 2:SUITE C
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61109-6334
Practice Address - Country:US
Practice Address - Phone:815-874-1314
Practice Address - Fax:815-874-1363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========-003Medicaid
IL=========008Medicaid
0393850069Medicare NSC