Healthcare Provider Details

I. General information

NPI: 1073073078
Provider Name (Legal Business Name): MIDWEST COMPANIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 03/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 PLUM STREET SUITE #220
RED WING MN
55066
US

IV. Provider business mailing address

1620 CENTRAL AVE NE SUITE #107
MINNEAPOLIS MN
55413
US

V. Phone/Fax

Practice location:
  • Phone: 507-225-0202
  • Fax: 612-444-3292
Mailing address:
  • Phone: 612-584-4858
  • Fax: 612-444-3292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHAEL JOHN MCHUGH
Title or Position: PRESIDENT
Credential:
Phone: 612-584-4858