Healthcare Provider Details

I. General information

NPI: 1013903533
Provider Name (Legal Business Name): BREATHING DISORDERS SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 04/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8241 S WALKER AVE
OKLAHOMA CITY OK
73139-9401
US

IV. Provider business mailing address

PO BOX 269035
OKLAHOMA CITY OK
73126-9035
US

V. Phone/Fax

Practice location:
  • Phone: 405-635-0004
  • Fax: 405-635-0009
Mailing address:
  • Phone: 405-635-0004
  • Fax: 405-635-0009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number168681
License Number StateOK

VIII. Authorized Official

Name: ELLA TRUITT
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 405-635-0004