Provider Demographics
NPI:1598820581
Name:BREATH OF LIFE HOME HEALTH EQUIPMENT, INC.
Entity Type:Organization
Organization Name:BREATH OF LIFE HOME HEALTH EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:D
Authorized Official - Last Name:FINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-783-7200
Mailing Address - Street 1:1002 N PARKERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-3613
Mailing Address - Country:US
Mailing Address - Phone:337-783-7263
Mailing Address - Fax:337-783-8996
Practice Address - Street 1:1472 S COLLEGE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2921
Practice Address - Country:US
Practice Address - Phone:337-234-0085
Practice Address - Fax:337-261-0760
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARMICHAEL'S CASHWAY PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-27
Last Update Date:2011-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BC3200X, 332BD1200X, 332BP3500X, 335E00000X
LA332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAC08424446OtherMEDICARE SUBMITTER #
LA1980102Medicaid
LA1980102Medicaid
LA657870001Medicare ID - Type UnspecifiedMEDICARE PROVIDER #