Provider Demographics
NPI:1902918477
Name:EHS PULMONARY AND CRITICAL CARE LLC
Entity Type:Organization
Organization Name:EHS PULMONARY AND CRITICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, EHS PRACTICE ADMIN.
Authorized Official - Prefix:MR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:K
Authorized Official - Last Name:COLBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-473-7977
Mailing Address - Street 1:910 W 5TH AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2967
Mailing Address - Country:US
Mailing Address - Phone:509-625-1915
Mailing Address - Fax:509-625-1919
Practice Address - Street 1:910 W 5TH AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2967
Practice Address - Country:US
Practice Address - Phone:509-625-1915
Practice Address - Fax:509-625-1919
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMPIRE HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-31
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00027787207RC0200X, 207RP1001X, 207RS0012X
WAMD00018532207RC0200X
WAMD00047235207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G26940Medicare UPIN
I33692Medicare UPIN
A07914Medicare UPIN