MEDICARE: BREATHING DISORDERS SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	168681	OK

General Provider Information

NPI Number	:	1013903533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BREATHING DISORDERS SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 269035
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73126-9035
Country	:	US
Telephone Number	:	405-635-0004
Fax Number	:	405-635-0009

Provider Business Practice Location Address
First Line	:	8241 S WALKER AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-9401
Country	:	US
Telephone Number	:	405-635-0004
Fax Number	:	405-635-0009

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	ELLA TRUITT
Credential	:
Telephone Number	:	405-635-0004

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	04/04/2008

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