1013384627 NPI number — BREATHE EASY MEDICAL SUPPLIES INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013384627 NPI number — BREATHE EASY MEDICAL SUPPLIES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BREATHE EASY MEDICAL SUPPLIES INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013384627
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40 16TH ST. SW SUITE G
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
855-461-3279
Provider Business Mailing Address Fax Number:
855-568-7587

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 16TH ST. SW SUITE G
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-568-7587
Provider Business Practice Location Address Fax Number:
855-461-3279
Provider Enumeration Date:
08/31/2015

Additional Information

Authorized Official

Authorized Official Last Name:
BOUAPAENGPHAN
Authorized Official First Name:
TINA
Authorized Official Middle Name:
AE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
507-722-7587

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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