Organization · Type 2 NPI
Breakaway, Inc
Customized Equipment (DME) · Garden City, ID
NPI number
1700055209
Active
Practice location
106 E 39th St
Garden City, ID 83714-6440
Fax (208) 342-4507
Mailing address
PO Box 1593
Boise, ID 83701-1593
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Customized Equipment (DME) Primary | 332BC3200X | 047307 (ID) |
Customized Equipment (DME): Definition to come...
About NPI 1700055209
Breakaway, Inc's National Provider Identifier is 1700055209, issued on Feb 28, 2008. The primary taxonomy on file is Customized Equipment (DME) (332BC3200X), and the practice location is in Garden City, ID. The record was last updated on Nov 30, 2011.