Healthcare Provider Details

I. General information

NPI: 1972902641
Provider Name (Legal Business Name): JUST BREATHE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2014
Last Update Date: 08/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E PULASKI HWY SUITE 106
ELKTON MD
21921-6737
US

IV. Provider business mailing address

PO BOX 428
ELKTON MD
21922-0428
US

V. Phone/Fax

Practice location:
  • Phone: 410-398-0590
  • Fax: 442-485-6531
Mailing address:
  • Phone: 410-398-0590
  • Fax: 443-485-6531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: HASSAN HAYAT
Title or Position: MANAGING MEMEBER
Credential:
Phone: 410-398-0590