Basic Information
| Provider Information | |||||||||
| NPI: | 1639781149 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PROCAIR INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24000 BROADWAY AVE | ||||||||
| Address2: | |||||||||
| City: | OAKWOOD VILLAGE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441466329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402323000 | ||||||||
| FaxNumber: | 4402323411 | ||||||||
| Practice Location | |||||||||
| Address1: | 5500 MAIN ST STE 340 | ||||||||
| Address2: | |||||||||
| City: | WILLIAMSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142216737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8669075337 | ||||||||
| FaxNumber: | 4402323411 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2020 | ||||||||
| LastUpdateDate: | 08/18/2020 | ||||||||
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| AuthorizedOfficialLastName: | BUNN | ||||||||
| AuthorizedOfficialFirstName: | JUDITH | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | COMPLIANCE MANGER | ||||||||
| AuthorizedOfficialTelephone: | 4402323000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | PROCAIR INC | ||||||||
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| NPICertificationDate: | 08/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BX2000X | N | Suppliers | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.