Provider Demographics
NPI:1053663039
Name:BREATHEAMERICA COLUMBUS LLC
Entity Type:Organization
Organization Name:BREATHEAMERICA COLUMBUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP MANAGED CARE
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-7122
Mailing Address - Street 1:6810 PERIMETER DR
Mailing Address - Street 2:UNIT 200
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-8005
Mailing Address - Country:US
Mailing Address - Phone:615-665-7122
Mailing Address - Fax:615-665-8776
Practice Address - Street 1:6810 PERIMETER DR
Practice Address - Street 2:UNIT 200
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-8005
Practice Address - Country:US
Practice Address - Phone:615-665-7122
Practice Address - Fax:615-665-8776
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BREATHEAMERICA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-15
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty