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General NPI Number Information
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NPI Number | 1528095577
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Entity Type | Organization
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Legal Business Name | BREATH OF LIFE HOME HEATH EQUIPMENT, INC
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 101 ENERGY PARKWAY SUITE C
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City | LAFAYETTE
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State | LA
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Zip | 70508
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Country | US
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Telephone | 337-269-9644
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Fax | 337-269-9667
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Provider Business Mailing Address
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Address Line | 101 ENERGY PKWY SUITE C
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City | LAFAYETTE
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State | LA
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Zip | 70598
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Country | US
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Telephone | 337-269-9644
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Fax | 337-269-9667
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN KENT WHIPP
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Credential | RRT
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Telephone | 337-269-9644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | L00723
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License Number State | LA
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