MEDICARE: AIRWAY BREATHING CO

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)	0206008375	VA

General Provider Information

NPI Number	:	1336407733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AIRWAY BREATHING CO

Provider Business Mailing Address
First Line	:	28 RESEARCH DR STE A
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-1364
Country	:	US
Telephone Number	:	804-864-8700
Fax Number	:	804-864-8702

Provider Business Practice Location Address
First Line	:	7439 WHITEPINE RD
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23237-2255
Country	:	US
Telephone Number	:	804-864-8700
Fax Number	:	804-864-8702

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JUSTIN PATRICK MILLER
Credential	:
Telephone Number	:	757-826-2600

Provider Enumeration Date	:	04/24/2012
Last Update Date	:	06/07/2019

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