Miracle Durable Medical Equipment Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

27-5-3314 Issued in OK

Legal business name

MIRACLE DURABLE MEDICAL EQUIPMENT INC

Doing business as

Breath of Life Sleep and Respiratory Care

Practice address

208 W. Evergreen Street
Durant, OK 74701

Phone

(580) 924-3900

Fax

(580) 924-3902

NPI assigned

Aug 30, 2006

Last updated

Oct 5, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Henry Blume Loe Jr.

Title

Ceo Owner

Phone

(903) 893-1301

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Breath of Life Sleep and Respiratory Care Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1477663797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1395",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750911395",
            "telephone_number": "580-924-3900",
            "fax_number": "580-924-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 W. EVERGREEN STREET",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "74701",
            "telephone_number": "580-924-3900",
            "fax_number": "580-924-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE DURABLE MEDICAL EQUIPMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "LOE",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "BLUME",
        "authorized_official_title_or_position": "CEO OWNER",
        "authorized_official_telephone_number": "903-893-1301",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0064720",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OK",
            "license": "27-5-3314",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF TEXAS",
            "identifier": "531794",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153613801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200493700A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breath of Life Sleep and Respiratory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carla Dawn Milligan
• Michelle Colleen Milligan
• Eric Stewart Mills, D.O.
• Landry Mills
• Stormie Leigh Milne
• Jessica Lynn Mitchell, BHCM II
• Jillian Mize, DBH, LPC
• Shelly Gwyn Moffatt
• Fnu Mohammed Mahmoodurrahman, M.D.
• Robert Allen Moody II, DO

• Durable Medical Equipment & Medical Supplies in Durant, OK
• Providers in Durant, OK by specialty
• Durable Medical Equipment & Medical Supplies in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.