Healthcare Provider Details

I. General information

NPI: 1285282855
Provider Name (Legal Business Name): BREATHE EASY MEDICAL SOLUTIONS LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 08/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18490 W LOUISE DR
SURPRISE AZ
85387-1470
US

IV. Provider business mailing address

18490 W LOUISE DR
SURPRISE AZ
85387-1470
US

V. Phone/Fax

Practice location:
  • Phone: 530-586-6970
  • Fax:
Mailing address:
  • Phone: 530-586-6970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: KYLE SKOUSEN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 530-586-6970