Provider Demographics
NPI:1336406891
Name:PULMONARY ASSOCIATES INCORPORATED
Entity Type:Organization
Organization Name:PULMONARY ASSOCIATES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:W
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:304-257-3744
Mailing Address - Street 1:96 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-1638
Mailing Address - Country:US
Mailing Address - Phone:304-359-2070
Mailing Address - Fax:304-822-4225
Practice Address - Street 1:86 PINE SWAMP RD
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-2655
Practice Address - Country:US
Practice Address - Phone:304-788-2335
Practice Address - Fax:304-788-4372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-20
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0329590004Medicare NSC