# MINERAL WELLS MEDICAL SUPPLY, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BRECKENRIDGE MEDICAL SUPPLY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740657105
- **Authorized official:** REBBEKAH DAVIS (OWNER)
- **Authorized official phone:** (940) 325-2706

## Contact information

- **Practice address:** 801 E WALKER ST, BRECKENRIDGE, TX 76424-3745
- **Practice address phone:** (254) 559-2345
- **Mailing address:** PO BOX 1152, MINERAL WELLS, TX 76068-1152

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 1001185 | TX | Yes |

## Other

- **Enumeration date:** 09/01/2015
- **Last updated:** 10/15/2021