Provider Demographics
NPI:1154753259
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/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:GINGLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-785-6622
Mailing Address - Street 1:3538 N ROMERO RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-5275
Mailing Address - Country:US
Mailing Address - Phone:888-785-6622
Mailing Address - Fax:
Practice Address - Street 1:760 VIA LATA
Practice Address - Street 2:SUITE 100
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-3977
Practice Address - Country:US
Practice Address - Phone:888-785-6622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1291650001Medicare NSC
NV1291650004Medicare NSC
CA1291650003Medicare NSC