Miratech Laboratory Services

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MIRATECH LABORATORY SERVICES

Practice address

11404 Hanbury Manor Blvd
Noblesville, IN 46060-7179

Phone

(800) 840-1673

Fax

(317) 830-6393

NPI assigned

Mar 14, 2023

Organization subpart

No

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

Authorized official

Name

Jimmie Nichols

Title

Ceo

Phone

(317) 509-2016

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678752000000",
    "number": "1194426387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11404 HANBURY MANOR BLVD",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460607179",
            "telephone_number": "800-840-1673",
            "fax_number": "317-830-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11404 HANBURY MANOR BLVD",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460607179",
            "telephone_number": "800-840-1673",
            "fax_number": "317-830-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRATECH LABORATORY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "JIMMIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-509-2016"
    },
    "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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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.