NPIMap

Organization Active NPI

Mineral Wells Medical Supply, Inc

Doing business as Breckenridge Medical Supply

  • Durable Medical Equipment & Medical Supplies
  • Breckenridge, TX
National Provider Identifier
1740657105
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
1001185 Issued in TX
Legal business name
MINERAL WELLS MEDICAL SUPPLY, INC
Doing business as
Breckenridge Medical Supply
Practice address
801 E Walker St
Breckenridge, TX 76424-3745
Phone
(254) 559-2345
NPI assigned
Sep 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Authorized official

Name
Rebbekah Davis
Title
Owner
Phone
(940) 325-2706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1001185 TX Primary

Addresses

Primary practice location

801 E Walker St
Breckenridge, TX 76424-3745

Mailing address

PO Box 1152
Mineral Wells, TX 76068-1152

Other names 1

  • BRECKENRIDGE MEDICAL SUPPLY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mineral Wells Medical S2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634256000000",
    "number": "1740657105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1152",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760681152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E WALKER ST",
            "city": "BRECKENRIDGE",
            "state": "TX",
            "postal_code": "764243745",
            "telephone_number": "254-559-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINERAL WELLS MEDICAL SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-01",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "REBBEKAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-325-2706"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "1001185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRECKENRIDGE MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Breckenridge, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.