Provider Demographics
NPI:1083304729
Name:BREATHE EASY SUPPLY LLC
Entity Type:Organization
Organization Name:BREATHE EASY SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:DYNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-868-5535
Mailing Address - Street 1:1030 WALLACE DR APT B
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-4604
Mailing Address - Country:US
Mailing Address - Phone:561-908-2876
Mailing Address - Fax:
Practice Address - Street 1:1030 WALLACE DR APT B
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-4604
Practice Address - Country:US
Practice Address - Phone:561-908-2876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies