Mackmiller Design Build

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

20428435 Issued in MN

Legal business name

MACKMILLER DESIGN BUILD

Practice address

15694 Village Woods Dr
Eden Prairie, MN 55347-1441

Phone

(952) 949-8600

Fax

(952) 294-0262

NPI assigned

Apr 6, 2009

Organization subpart

No

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

Authorized official

Name

Mark A. Mackmiller, CAPS

Title

Co-Owner

Phone

(952) 949-8600

Specialties & licenses 1

Addresses

Other names 1

• Home for Good Doing business as

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

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238976000000",
    "number": "1508008525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15694 VILLAGE WOODS DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553471441",
            "telephone_number": "952-949-8600",
            "fax_number": "952-294-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15694 VILLAGE WOODS DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553471441",
            "telephone_number": "952-949-8600",
            "fax_number": "952-294-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACKMILLER DESIGN BUILD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-06",
        "last_updated": "2009-04-06",
        "status": "A",
        "authorized_official_last_name": "MACKMILLER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "952-949-8600",
        "authorized_official_credential": "CAPS"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "MN",
            "license": "20428435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home for Good",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alice Macdonald, MBCHB
• Christopher James Macdonald, MD, PHD
• Quincee Lynn Macgibbon, CNP
• Kalene Nicole Hayes Mach, DO
• Husam Mackawi
• Shahzad Madanipour, M.D.
• Faith Mader
• Lora Madjar-Farley, MA
• Coleman Jensen Madland
• Magnitude Therapy Services LLC

• Customized Equipment (DME) in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Customized Equipment (DME) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.