Provider Demographics
NPI:1245358621
Name:CHILDREN'S PULMONARY & SLEEP SERVICES, P.C
Entity type:Organization
Organization Name:CHILDREN'S PULMONARY & SLEEP SERVICES, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAIM
Authorized Official - Middle Name:S
Authorized Official - Last Name:BASHIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-266-7733
Mailing Address - Street 1:PO BOX 28596
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-8596
Mailing Address - Country:US
Mailing Address - Phone:804-266-7733
Mailing Address - Fax:804-266-7736
Practice Address - Street 1:2103 E PARHAM RD
Practice Address - Street 2:SUITE - 200
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-2235
Practice Address - Country:US
Practice Address - Phone:804-266-7733
Practice Address - Fax:804-266-7736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012385112080S0012X, 2080P0214X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep MedicineGroup - Multi-Specialty
No2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric PulmonologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4382553OtherAETNA
VA010279364Medicaid
10012961OtherOPTIMA
247341OtherANTHEM
VA010345715Medicaid
0345243OtherCIGNA
198076OtherANTHEM
445589OtherSOUTHERN HEALTH
2166960OtherUNITEDHEALTHCARE
4382553OtherAETNA
VAGC1052Medicare PIN