BREAKAWAY, INC (NPI# 1700055209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700055209 |
| Entity Type | Organization |
| Organization Name | BREAKAWAY, INC |
| Practice Address |
106 E 39th St Garden City ID 83714-6440 |
| Mailing Address |
Po Box 1593 Boise ID 83701-1593 |
| Practice Telephone | 2083424506 |
| Practice Fax Number | 2083424507 |
| Mailing Telephone | 2083424506 |
| Mailing Fax Number | 2083424507 |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2011-11-30 |
| Authorized Official Name | MRS. CAROL C ELLIOTT (VICE-PRESIDENT) |
| Authorized Official Telephone | 2083424506 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
047307 | ID | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 8061158 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | BREAKAWAY, INC. | Box 155, Sheffield, VT 05866 |
| Oregon Corporations, Companies and Business Names | BREAKAWAY, INC. | 256 Nw Delaware, Bend, OR 97703 |
| Massachusetts Corporations | BREAKAWAY, INC. | 12 Pollock Dr., Middleton, MA 01949 |
| Street Address |
106 E 39TH ST |
| City | GARDEN CITY |
| State | ID |
| Zip Code | 83714-6440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1437608007 | Carrie Boroughs Breaux | Ophthalmology | 5019 N Sawyer Ave, Garden City, ID 83714 | 2016-09-23 |
| 1841646007 | Alliance Medical Group, LLC | Family Medicine | 5601 W. Chinden Blvd., Garden City, ID 83714 | 2016-05-06 |
| 1134580467 | Rebecca Gillet | Physical Therapist | 6576 W Dufferin Ct, Boise, ID 83714 | 2016-03-15 |
| 1063816007 | Ingri Suzanne Koloski | Counselor | 8969 West Hepburn Lane, Garden City, ID 83714 | 2014-10-20 |
| 1679909329 | Anile Nina | Counselor | 5484 N Gary Lane, Boise, ID 83714 | 2013-09-25 |
| 1215360292 | William Blake Bybee | Dentist | 5833 W. Hidden Springs Dr., Boise, ID 83714 | 2013-08-14 |
| 1871833327 | Charmaine Read | Social Worker | 123 E. 44th St, Ste. A, Garden City, ID 83714 | 2013-02-20 |
| 1811206576 | Bennett Medical Services | Durable Medical Equipment & Medical Supplies | 5220 Sawyer Court, Suite D, Garden City, ID 83714 | 2010-09-29 |
| 1073780680 | Barry Lynn Williams | Pharmacist | 7020 W State Street, Boise, ID 83714 | 2008-05-13 |
| Find all providers in zip 83714 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215437397 | Brace Yourself | Durable Medical Equipment & Medical Supplies | 1510 Taylor Plz E, Garden City, KS 67846-4055 | 2018-02-15 |
| 1417482423 | Premier Health Solutions Dme Inc | Durable Medical Equipment & Medical Supplies | 29484 Ford Rd, Garden City, MI 48135-2318 | 2017-04-27 |
| 1629264189 | Robert Lee Baker | Durable Medical Equipment & Medical Supplies | 211 W Kansas Ave, Garden City, KS 67846-5362 | 2007-09-19 |
| 1538127089 | Griffin Home Health Care Inc | Durable Medical Equipment & Medical Supplies | 3911 Old Louisville Rd Ste 105, Garden City, GA 31408-2622 | 2006-05-03 |
| 1215933791 | Home Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 1050 Stewart Avenue, Suite 120, Garden City, NY 11530 | 2005-06-21 |
| 1043717135 | Premier Health Solution Dme Inc | Durable Medical Equipment & Medical Supplies | 29484 Ford Rd, Garden City, MI 48135-2318 | 2018-04-06 |
| 1619416120 | Jeffrey J Stasch | Durable Medical Equipment & Medical Supplies | 1812 E Mary St, Garden City, KS 67846-3652 | 2017-02-16 |
| 1730532607 | Ann D. Tobin, Dds | Durable Medical Equipment & Medical Supplies | 520 Franklin Ave, Suite 126, Garden City, NY 11530-5806 | 2016-07-15 |
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| 1356876726 | Norco, Inc | Durable Medical Equipment & Medical Supplies | 204 W Ironwood Dr Ste 204, Coeur D Alene, ID 83814-1411 | 2017-04-24 |
| 1679938294 | Foot and Ankle Clinic of Spokane Inc | Durable Medical Equipment & Medical Supplies | 8944 N Hess St # A, Hayden, ID 83835-9183 | 2015-12-25 |
| 1821436718 | Kinghorn Medical LLC | Durable Medical Equipment & Medical Supplies | 248 S Cole Rd, Bldg #7, Boise, ID 83709-0934 | 2013-06-13 |
| 1174890628 | Norco, Inc | Durable Medical Equipment & Medical Supplies | 1350 Parkway Dr Ste 26, Blackfoot, ID 83221-1657 | 2011-11-29 |
| 1033486865 | Wheelchair Access Vans | Durable Medical Equipment & Medical Supplies | 6893 Supply Way, Boise, ID 83716-5539 | 2011-11-22 |
| 1093091555 | Nationwidebath Com LLC | Durable Medical Equipment & Medical Supplies | 647 S Stibnite Ave, Kuna, ID 83634-1992 | 2011-10-28 |
| 1154618510 | Bellevue Healthcare II Inc | Durable Medical Equipment & Medical Supplies | 115 E Harrison Ave, Coeur D Alene, ID 83814-3238 | 2011-07-06 |
| 1477877934 | United Seating and Mobility LLC | Durable Medical Equipment & Medical Supplies | 1270 E Fairview Ave, Suite 150, Meridian, ID 83642-1844 | 2010-03-26 |
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| City | GARDEN CITY |
| Zip Code | 83714 |
Please comment or provide details below to improve the information on BREAKAWAY, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.