Provider Demographics
NPI:1992405328
Name:SODEL PULMONARY CENTER, LLC
Entity type:Organization
Organization Name:SODEL PULMONARY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TIBBETT-WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DBA, MSM-HCA, RRT
Authorized Official - Phone:302-515-9666
Mailing Address - Street 1:20163 OFFICE CIR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-0849
Mailing Address - Country:US
Mailing Address - Phone:302-515-9666
Mailing Address - Fax:833-449-5068
Practice Address - Street 1:20163 OFFICE CIR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-3197
Practice Address - Country:US
Practice Address - Phone:302-515-9666
Practice Address - Fax:833-449-5068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome HealthGroup - Multi-Specialty
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service