BREAKWATER MEDICAL LLC (NPI# 1710236344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710236344 |
| Entity Type | Organization |
| Organization Name | BREAKWATER MEDICAL LLC |
| Practice Address |
720 Milwood Ave Venice CA 90291-3829 |
| Mailing Address |
210 N Tustin Ave Santa Ana CA 92705-3807 |
| Practice Telephone | 7143471010 |
| Practice Fax Number | 7146471245 |
| Mailing Telephone | 7143471010 |
| Mailing Fax Number | 7146471245 |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |
| Authorized Official Name | MR. PATRICK CAHILL (OWNER) |
| Authorized Official Telephone | 7143471010 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Street Address |
720 MILWOOD AVE |
| City | VENICE |
| State | CA |
| Zip Code | 90291-3829 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033629837 | Dylan Booth | Dentist | 601 Vernon Ave, Venice, CA 90291 | 2017-10-05 |
| 1467979500 | Linda Sittler | Registered Nurse | 1025 Palms Ave, Venice, CA 90291 | 2017-08-29 |
| 1003218660 | Patricia Guadalupe Rivas | Counselor | 717 Lincoln Blvd., Venice, CA 90291 | 2014-09-25 |
| 1497016877 | Carrie Lynn Kowalski | Physician Assistant | 604 Rose Avenue, Venice, CA 90291 | 2012-06-02 |
| 1821364761 | Cheryl Lynn Perkins | Nutritionist | 215 Culver Boulevard, # 5203, Playa Del Rey, CA 90291 | 2012-03-26 |
| 1629391875 | James L. Hoff | Optometrist | 1636 Abbot Kinney Blvd., Venice, CA 90291 | 2010-03-02 |
| 1720315096 | Kristen Nicol Leishman | Counselor | 911 Coeur D'alene Ave, Venice, CA 90291 | 2009-11-06 |
| 1922237882 | David Anthony Garcia | Physician Assistant | 15031 Rinaldi St., Providence Holy Cross Medical Center Ed, Mission Hills, CA 90291 | 2009-07-13 |
| 1548411010 | David Watts | Acupuncturist | 307 S. Robertson Blvd, Beverly Hills, CA 90291 | 2008-10-02 |
| 1184891699 | Judy Alexander | Voluntary or Charitable | 204 Hampton Drive, St Joseph Center, Venice, CA 90291 | 2008-05-14 |
| Find all providers in zip 90291 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861047375 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 12165 Mercado Drive, Venice, FL 34293 | 2019-08-02 |
| 1255822615 | All Around Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 242 Blue Juniper Blvd, Venice, FL 34292-1733 | 2018-05-22 |
| 1023538345 | Mary Laurie | Durable Medical Equipment & Medical Supplies | 234 Tamiami Trail S, Venice, FL 34285 | 2017-06-27 |
| 1508317827 | Beauty Plus Wigs Hats & Lingerie Inc. | Durable Medical Equipment & Medical Supplies | 545 Us Highway 41 Byp N, Venice, FL 34285-6040 | 2016-10-21 |
| 1033576137 | Broy Enterprises Inc. | Durable Medical Equipment & Medical Supplies | 1205 U.S. 41 Bypass South, Venice, FL 34285 | 2016-01-20 |
| 1669895538 | Stateserv Medical, LLC | Durable Medical Equipment & Medical Supplies | 756 Commerce Dr Ste 2, Venice, FL 34292-1706 | 2014-01-29 |
| 1982026662 | Samson Merger Sub, LLC | Durable Medical Equipment & Medical Supplies | 1254 Jacaranda Blvd, Venice, FL 34292-4508 | 2014-01-14 |
| 1144598038 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 391 Tamiami Trl S, Venice, FL 34285-2423 | 2011-12-06 |
| 1811286974 | Hanger Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 802 Pinebrook Rd, Venice, FL 34285-7103 | 2011-03-29 |
| 1144548421 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 4173 Tamiami Trl S, Venice, FL 34293-5111 | 2010-05-11 |
| Find all providers in VENICE | ||||
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| 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.