Provider Demographics
NPI:1780639708
Name:PULMONARY CARE INC
Entity Type:Organization
Organization Name:PULMONARY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRIT
Authorized Official - Middle Name:J
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:610-853-1985
Mailing Address - Street 1:320 DARBY RD
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083
Mailing Address - Country:US
Mailing Address - Phone:610-853-1985
Mailing Address - Fax:610-853-6998
Practice Address - Street 1:320 DARBY RD
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083
Practice Address - Country:US
Practice Address - Phone:610-853-1985
Practice Address - Fax:610-853-6998
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PULMONARY CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-24
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAYM000949L332B00000X
NJ43ZA00455700332B00000X
PA3000007178332B00000X
332BC3200X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7182347OtherAETNA
PA222119OtherHIGHMARK BC
PA1008289390001Medicaid
PA3456404OtherAETNA
PA222119OtherHIGHMARK BC