Provider Demographics
NPI:1134311665
Name:EASTERN PULMONARY & SLEEP, PC
Entity type:Organization
Organization Name:EASTERN PULMONARY & SLEEP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MEADOWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-853-8152
Mailing Address - Street 1:100 PILOT MEDICAL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3411
Mailing Address - Country:US
Mailing Address - Phone:205-854-8084
Mailing Address - Fax:205-815-9341
Practice Address - Street 1:100 PILOT MEDICAL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3411
Practice Address - Country:US
Practice Address - Phone:205-854-8084
Practice Address - Fax:205-815-9341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22001207RP1001X
AL13565207RP1001X
AL29247207RP1001X
AL13732207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty