Provider Demographics
NPI:1760440911
Name:PULMTECH, LLC
Entity Type:Organization
Organization Name:PULMTECH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:440-716-0661
Mailing Address - Street 1:21380 LORAIN RD
Mailing Address - Street 2:104
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-2143
Mailing Address - Country:US
Mailing Address - Phone:440-331-2382
Mailing Address - Fax:440-331-5055
Practice Address - Street 1:21380 LORAIN RD
Practice Address - Street 2:104
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-2143
Practice Address - Country:US
Practice Address - Phone:440-331-2382
Practice Address - Fax:440-331-5055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279P1004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary DiagnosticsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPUID02941Medicare PIN