Midwest Medical Holdings LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

261420 Issued in MN

Legal business name

MIDWEST MEDICAL HOLDINGS LLC

Practice address

8400 Coral Sea St NE
Saint Paul, MN 55112-4398

Phone

(763) 780-0218

Fax

(763) 780-2381

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Larry Lindberg, RPH

Title

Pic/Owner

Phone

(763) 780-0218

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• RX EXPRESS Doing business as

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428883200000",
    "number": "1609925965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 CORAL SEA ST NE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551124398",
            "telephone_number": "763-780-0218",
            "fax_number": "763-780-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 CORAL SEA ST NE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551124398",
            "telephone_number": "763-780-0218",
            "fax_number": "763-780-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST MEDICAL HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2015-04-13",
        "status": "A",
        "authorized_official_last_name": "LINDBERG",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "PIC/OWNER",
        "authorized_official_telephone_number": "763-780-0218",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MN",
            "license": "261420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "950816300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2047435",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RX EXPRESS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Midwest Medical Holdings LLC
• Midwest Radiology Outpatient Imaging, LLC
• Midwest Stabilization Services Inc
• Deborah Kim Mielke, M.D.
• Matthew Lester Mielke, M.D.

• Long Term Care Pharmacy in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Long Term Care Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.