Provider Demographics
NPI:1205006640
Name:DANIEL A. KING
Entity Type:Organization
Organization Name:DANIEL A. KING
Other - Org Name:BREEZE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-521-3880
Mailing Address - Street 1:06899 44TH ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49026-9706
Mailing Address - Country:US
Mailing Address - Phone:269-521-3880
Mailing Address - Fax:269-521-3246
Practice Address - Street 1:06899 44TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:MI
Practice Address - Zip Code:49026-9706
Practice Address - Country:US
Practice Address - Phone:269-521-3880
Practice Address - Fax:269-521-3246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4307300Medicaid