Provider Demographics
NPI:1194806265
Name:BRANSON PULMONOLOGY AND SLEEP LLC
Entity type:Organization
Organization Name:BRANSON PULMONOLOGY AND SLEEP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HABIB
Authorized Official - Middle Name:G
Authorized Official - Last Name:MUNSHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-334-5864
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65615
Mailing Address - Country:US
Mailing Address - Phone:417-334-5864
Mailing Address - Fax:417-334-4978
Practice Address - Street 1:875 E STATE HIGHWAY 76
Practice Address - Street 2:SUITE A
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616
Practice Address - Country:US
Practice Address - Phone:417-334-5864
Practice Address - Fax:417-334-4978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO116317261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO15213001Medicare PIN
MO000013796Medicare PIN