Provider Demographics
NPI:1831171685
Name:PULMONAIRE INC
Entity type:Organization
Organization Name:PULMONAIRE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:M
Authorized Official - Last Name:STILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-593-0202
Mailing Address - Street 1:1574 ARROW HIGHWAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-3599
Mailing Address - Country:US
Mailing Address - Phone:909-593-0202
Mailing Address - Fax:909-593-0209
Practice Address - Street 1:1574 ARROW HIGHWAY
Practice Address - Street 2:SUITE A
Practice Address - City:LA VERNE
Practice Address - State:CA
Practice Address - Zip Code:91750-3599
Practice Address - Country:US
Practice Address - Phone:909-593-0202
Practice Address - Fax:909-593-0209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME02044FMedicaid
0995500001Medicare NSC