MEDICARE: MIDTOWN INVESTMENTS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	20050170	UT

General Provider Information

NPI Number	:	1730294737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDTOWN INVESTMENTS LLC

Provider Business Mailing Address
First Line	:	7100 NORTHLAND CIR N
Second Line	:	SUITE 410
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55428-1548
Country	:	US
Telephone Number	:	763-535-0118
Fax Number	:	612-294-3289

Provider Business Practice Location Address
First Line	:	2550 S DECKER LAKE BLVD STE 23
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-7656
Country	:	US
Telephone Number	:	801-972-2466
Fax Number	:	801-972-2488

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JASON R RICHARDSON
Credential	:
Telephone Number	:	601-842-7380

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	09/01/2021

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