Organization
MISSOURI BREAKS INDUSTRIES RESEARCH, INC.
Active
Other names
Missouri Breaks Durable Medical Equipment
Organization subpart
No
Provider details
NPI number
Authorized official
BLAINE O'LEARY (MANAGER)
(605) 964-3418
Entity
Organization
Contact information
Practice address
118 S WILLOW ST, EAGLE BUTTE, SD 57625
(605) 964-3418
(605) 964-3415
Mailing address
PO BOX 1824, EAGLE BUTTE, SD 57625-1824
(605) 964-3418
(605) 964-3415
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4995628
BLUECROSS/BLUESHIELD
SD
05
—
9161950
—
SD
01
—
9218369
DAKOTA CARE
SD
Enumeration date
01/12/2006
Last updated
08/17/2018
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