Midwest Medical Equipment & Supplies, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

MIDWEST MEDICAL EQUIPMENT & SUPPLIES, INC

Practice address

530 E 2ND St
Duluth, MN 55805-1913

Phone

(218) 786-4368

Fax

(218) 722-9988

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Kevin Boren

Title

Cfo

Phone

(218) 786-1009

Specialties & licenses 1

Addresses

Other identifiers 3

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• St. Mary'S Medical Center

  • Community Based Hospice Care Agency
  • Duluth, MN
  • NPI 1225089634

  Member Of

  NPD member

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667260800000",
    "number": "1083797252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051913",
            "telephone_number": "218-786-4368",
            "fax_number": "218-722-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051913",
            "telephone_number": "218-786-4368",
            "fax_number": "218-722-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST MEDICAL EQUIPMENT & SUPPLIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A",
        "authorized_official_last_name": "BOREN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "218-786-1009"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41660400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MN",
            "identifier": "32820MI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA COMMERCIAL INSURAN",
            "identifier": "8214390",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Genevieve Michalski
• Elisabeth Mary Michaud, DPT
• Nicole M Mickle, RBT
• Brian Midboe
• Luke David Midlo, M.D.
• Scott Anthony Mikesell, DO
• Nicholas J Milanovich, M.D.
• Corey Steven Milbrandt, DC
• Eda Bette Miles, MD, DC
• Erika M Miles, MD

• Prosthetic/Orthotic Supplier in Duluth, MN
• Providers in Duluth, MN by specialty
• Prosthetic/Orthotic Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.