Provider Demographics
NPI:1609862226
Name:BREATHING DISORDERS SERVICES
Entity type:Organization
Organization Name:BREATHING DISORDERS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TRUITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-635-0004
Mailing Address - Street 1:PO BOX 269035
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73126-9035
Mailing Address - Country:US
Mailing Address - Phone:405-635-0004
Mailing Address - Fax:405-635-0009
Practice Address - Street 1:1031 E LATHAM AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4425
Practice Address - Country:US
Practice Address - Phone:951-765-6985
Practice Address - Fax:951-765-1035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0979990005Medicare NSC