Provider Demographics
NPI:1528095577
Name:BREATH OF LIFE HOME HEATH EQUIPMENT, INC
Entity type:Organization
Organization Name:BREATH OF LIFE HOME HEATH EQUIPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:WHIPP
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:337-269-9644
Mailing Address - Street 1:101 ENERGY PKWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70598
Mailing Address - Country:US
Mailing Address - Phone:337-269-9644
Mailing Address - Fax:337-269-9667
Practice Address - Street 1:101 ENERGY PARKWAY
Practice Address - Street 2:SUITE C
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508
Practice Address - Country:US
Practice Address - Phone:337-269-9644
Practice Address - Fax:337-269-9667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL00723332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1980102Medicaid
LAC2615OtherBLUE CROSS
LA1980102Medicaid