Provider Demographics
NPI:1780637728
Name:BREATHE EZ, INC
Entity Type:Organization
Organization Name:BREATHE EZ, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER,DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ISMAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTES
Authorized Official - Suffix:
Authorized Official - Credentials:RRT, RCP
Authorized Official - Phone:910-642-0202
Mailing Address - Street 1:1014 NORTH J. K. POWELL BOULEVARD
Mailing Address - Street 2:PO BOX 1997
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-2640
Mailing Address - Country:US
Mailing Address - Phone:910-642-0202
Mailing Address - Fax:910-642-0110
Practice Address - Street 1:1014 NORTH J. K. POWELL BOULEVARD
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-2640
Practice Address - Country:US
Practice Address - Phone:910-642-0202
Practice Address - Fax:910-642-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704288Medicaid
NC5453330001Medicare ID - Type UnspecifiedMEDICARE NUMBER