Organization
BREATH OF LIFE O2 LLC.
Active
Other names
Breath of Life Home Medical Equipment and Respiratory Services Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN PHILLIP NAUYOKAS CRT (PRESIDENT/ CEO)
(317) 896-3048
Entity
Organization
Contact information
Practice address
17005 WESTFIELD PARK RD, SUITE 1, WESTFIELD, IN 46074-8428
(317) 896-3048
(866) 611-5501
Mailing address
17005 WESTFIELD PARK RD, SUITE 1, WESTFIELD, IN 46074-8428
(317) 896-3048
(866) 611-5501
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
IN
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200935180A
—
IN
01
—
6219550001
MEDICARE PTAN
—
Enumeration date
01/12/2009
Last updated
07/21/2022
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