Provider Demographics
NPI:1386076008
Name:BREATH OF LIFE HOME MEDICAL EQUIPMENT AND RESPIRATORY SERVICES INC.
Entity type:Organization
Organization Name:BREATH OF LIFE HOME MEDICAL EQUIPMENT AND RESPIRATORY SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:NAUYOKAS
Authorized Official - Suffix:
Authorized Official - Credentials:CRT
Authorized Official - Phone:317-896-3048
Mailing Address - Street 1:1200 S TILLOTSON OPAS
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-4806
Mailing Address - Country:US
Mailing Address - Phone:765-544-1380
Mailing Address - Fax:765-289-8191
Practice Address - Street 1:1200 S TILLOTSON OPAS
Practice Address - Street 2:SUITE 3
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-4806
Practice Address - Country:US
Practice Address - Phone:765-544-1380
Practice Address - Fax:765-289-8191
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BREATH OF LIFE HOME MEDICAL EQUIPMNET AND RESPIRATORY SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0134989104332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies