Midwest Medical Holdings LLC

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

License

260897 Issued in MN

Legal business name

MIDWEST MEDICAL HOLDINGS LLC

Practice address

8400 Coral Sea St NE Ste 100
Saint Paul, MN 55112-4395

Phone

(763) 780-1500

NPI assigned

Feb 16, 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

Ceo

Phone

(763) 780-1500

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• MIDWEST IV AND HOMECARE Doing business as

Tax ID family

Freedom Medical4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Midwest Medical Holdings LLC

  • Durable Medical Equipment & Medical Supplies
  • Waite Park, MN
  • NPI 1144543968
  NPD tax ID
• Midwest Medical Holdings LLC

  • Durable Medical Equipment & Medical Supplies
  • Richfield, MN
  • NPI 1326360926
  NPD tax ID
• Midwest Medical Holdings, LLC

  • Durable Medical Equipment & Medical Supplies
  • Blaine, MN
  • NPI 1215267778
  NPD tax ID

Locations

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476662400000",
    "number": "1902940604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18310",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554180310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 CORAL SEA ST NE STE 100",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551124395",
            "telephone_number": "763-780-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST MEDICAL HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2016-10-17",
        "status": "A",
        "authorized_official_last_name": "LINDBERG",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-780-1500",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "MN",
            "license": "260897",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "569860000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2047033",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIDWEST IV AND HOMECARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Midway Therapy Center LLC
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• Midwest Consulting LLC
• Midwest Innovative Neurodiagnostics LLP
• Midwest Medical Holdings LLC
• Midwest Radiology Outpatient Imaging, LLC
• Midwest Stabilization Services Inc
• Deborah Kim Mielke, M.D.
• Matthew Lester Mielke, M.D.
• Mietus NP Mental Health, LLC

• Home Infusion Therapy Pharmacy in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Home Infusion Therapy Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.