Healthcare Provider Details

I. General information

NPI: 1013384627
Provider Name (Legal Business Name): BREATHE EASY MEDICAL SUPPLIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2015
Last Update Date: 08/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 16TH ST. SW SUITE G
ROCHESTER MN
55904
US

IV. Provider business mailing address

40 16TH ST. SW SUITE G
ROCHESTER MN
55904
US

V. Phone/Fax

Practice location:
  • Phone: 855-568-7587
  • Fax: 855-461-3279
Mailing address:
  • Phone: 855-461-3279
  • Fax: 855-568-7587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateMN

VIII. Authorized Official

Name: TINA AE BOUAPAENGPHAN
Title or Position: OWNER
Credential:
Phone: 507-722-7587