Midwest Diagnostic Medicine, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MIDWEST DIAGNOSTIC MEDICINE, LLC

Practice address

11905 W Florissant Ave
Suite #200
Florissant, MO 63033-6778

Phone

(855) 984-1465

Fax

(855) 984-1469

NPI assigned

Oct 15, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Syed Haider

Title

Ceo

Phone

(636) 284-9012

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433462400000",
    "number": "1013311323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11905 W FLORISSANT AVE",
            "address_2": "SUITE #200",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336778",
            "telephone_number": "855-984-1465",
            "fax_number": "855-984-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11905 W FLORISSANT AVE",
            "address_2": "SUITE #200",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336778",
            "telephone_number": "855-984-1465",
            "fax_number": "855-984-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST DIAGNOSTIC MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-15",
        "last_updated": "2015-06-05",
        "status": "A",
        "authorized_official_last_name": "HAIDER",
        "authorized_official_first_name": "SYED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "636-284-9012",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Florissant, MO
• Providers in Florissant, MO by specialty
• Durable Medical Equipment & Medical Supplies in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.