Provider Demographics
NPI:1801168018
Name:PULMOCARE RESPIRATORY SERVICES, INC.
Entity type:Organization
Organization Name:PULMOCARE RESPIRATORY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GINGLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-785-6622
Mailing Address - Street 1:PO BOX 721
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-0721
Mailing Address - Country:US
Mailing Address - Phone:888-785-6622
Mailing Address - Fax:
Practice Address - Street 1:2675 E PATRICK LN STE 11
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-2437
Practice Address - Country:US
Practice Address - Phone:888-785-6622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PULMOCARE RESPIRATORY SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-02
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMP00661/MP00837332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1093761611OtherMEDICARE NPI