Provider Demographics
NPI:1043194772
Name:PNEUMOWAVE, INC.
Entity type:Organization
Organization Name:PNEUMOWAVE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAVASSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-373-3174
Mailing Address - Street 1:4900 OHEAR AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-5091
Mailing Address - Country:US
Mailing Address - Phone:860-373-3174
Mailing Address - Fax:
Practice Address - Street 1:421 FAYETTEVILLE ST STE 1100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27601-3000
Practice Address - Country:US
Practice Address - Phone:860-373-3174
Practice Address - Fax:860-373-3174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies