Organization
PROFESSIONAL PULMONARY SERVICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL DAVIDS (VICE PRESIDENT)
(856) 848-1146
Entity
Organization
Contact information
Practice address
27 E CENTRE ST, WOODBURY, NJ 08096-2415
(856) 848-2440
(856) 853-1146
Mailing address
27 E CENTRE ST, WOODBURY, NJ 08096-2415
(856) 848-2440
(856) 853-1146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000200291
AMERIHEALTH PPO
—
01
—
0002629000
KEYSTONE HEALTH PLANS
—
01
—
0017453
AETNA/USHC
—
05
—
2901501
—
NJ
Enumeration date
05/24/2005
Last updated
03/09/2011
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