Provider Demographics
NPI:1952436115
Name:PULMONARY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:PULMONARY ASSOCIATES, INC.
Other - Org Name:PULMONARY ASSOCIATES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-384-5101
Mailing Address - Street 1:PO BOX 81345
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89180-1345
Mailing Address - Country:US
Mailing Address - Phone:702-384-5101
Mailing Address - Fax:702-382-5675
Practice Address - Street 1:2000 WELLNESS WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4113
Practice Address - Country:US
Practice Address - Phone:702-384-5101
Practice Address - Fax:702-387-0104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVWQBCRMedicare ID - Type Unspecified