Provider Demographics
NPI:1295879823
Name:BREATHE OXYGEN SERVICES LLC
Entity type:Organization
Organization Name:BREATHE OXYGEN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SIMMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-867-1249
Mailing Address - Street 1:1450 SAM DAVIS RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-2736
Mailing Address - Country:US
Mailing Address - Phone:615-459-9945
Mailing Address - Fax:615-459-9946
Practice Address - Street 1:1450 SAM DAVIS RD
Practice Address - Street 2:SUITE 140
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-2736
Practice Address - Country:US
Practice Address - Phone:615-459-9945
Practice Address - Fax:615-459-9946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN928332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5929900001Medicare NSC