Organization
MOBILE MED INC
Active
Other names
Breathe Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY N BESON II (PRESIDENT)
(843) 285-7903
Entity
Organization
Contact information
Practice address
114 S CLIFTON AVE, LOUISVILLE, KY 40206-2406
(502) 896-8335
Mailing address
200 WEST 5TH STREET NORTH, SUMMERVILLE, SC 29483
(843) 285-7903
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
370765
ANTHEM BCBS
KY
05
—
50009464
—
KY
05
—
90011461
—
KY
Enumeration date
07/13/2006
Last updated
08/22/2020
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