Provider Demographics
NPI:1952447989
Name:CARDIOPULMONARY SERVICES INC.
Entity Type:Organization
Organization Name:CARDIOPULMONARY SERVICES INC.
Other - Org Name:CPS MEDICAL, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:FLY
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:434-984-2888
Mailing Address - Street 1:1932 ARLINGTON BLVD
Mailing Address - Street 2:STE. 2
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-1560
Mailing Address - Country:US
Mailing Address - Phone:434-984-2888
Mailing Address - Fax:434-984-3888
Practice Address - Street 1:1932 ARLINGTON BLVD
Practice Address - Street 2:STE. 2
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-1560
Practice Address - Country:US
Practice Address - Phone:434-984-2888
Practice Address - Fax:434-984-3888
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARDIOPULMONARY SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-29
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0206009337332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0414540002Medicare NSC