Organization
MIRACLE DURABLE MEDICAL EQUIPMENT INC
Active
Other names
Breath of Life Sleep and Respiratory Care
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY BLUME LOE JR. (CEO OWNER)
(903) 893-1301
Entity
Organization
Contact information
Practice address
208 W. EVERGREEN STREET, DURANT, OK 74701
(580) 924-3900
(580) 924-3902
Mailing address
PO BOX 1395, SHERMAN, TX 75091-1395
(580) 924-3900
(580) 924-3902
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0064720
TX
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
27-5-3314
OK
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153613801
—
TX
05
—
200493700A
—
OK
01
—
531794
BC/BS OF TEXAS
TX
Enumeration date
08/30/2006
Last updated
10/05/2023
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