MEDICARE: THE BREATHING ASSOCIATION PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	021790500	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3676775	OTHER		OTHER ID NUMBER

General Provider Information

NPI Number	:	1770750184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BREATHING ASSOCIATION PHARMACY

Provider Business Mailing Address
First Line	:	1520 OLD HENDERSON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3639
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 OLD HENDERSON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3639
Country	:	US
Telephone Number	:	614-457-4570
Fax Number	:	614-457-3777

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIE COLLART
Credential	:
Telephone Number	:	614-457-4570

Provider Enumeration Date	:	05/14/2008
Last Update Date	:	05/14/2008

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Directions to “THE BREATHING ASSOCIATION PHARMACY ” Practice Location

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