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General NPI Number Information
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NPI Number | 1609013747
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Entity Type | Organization
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Legal Business Name | BREATH OF LIFE O2 LLC.
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Dates
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Enumeration Date | 01/12/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 17005 WESTFIELD PARK RD SUITE 1
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City | WESTFIELD
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State | IN
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Zip | 46074-8428
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Country | US
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Telephone | 317-896-3048
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Fax | 866-611-5501
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Provider Business Mailing Address
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Address Line | 17005 WESTFIELD PARK RD SUITE 1
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City | WESTFIELD
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State | IN
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Zip | 46074-8428
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Country | US
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Telephone | 317-896-3048
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Fax | 866-611-5501
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Authorized Official
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Title or Position | PRESIDENT/ CEO
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Name | MR. JOHN PHILLIP NAUYOKAS
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Credential | CRT
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Telephone | 317-896-3048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State | IN
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