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General NPI Number Information
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NPI Number | 1023112687
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Entity Type | Organization
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Legal Business Name | MIDWEST INFUSION, INC.
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 238 MAIN ST
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City | COSHOCTON
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State | OH
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Zip | 43812-1507
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Country | US
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Telephone | 740-623-6431
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Fax | 740-622-0715
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Provider Business Mailing Address
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Address Line | PO BOX 699
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City | ZANESVILLE
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State | OH
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Zip | 43702-0699
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Country | US
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Telephone | 740-623-6431
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Fax | 740-622-0715
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRAD KENNEDY
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Credential |
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Telephone | 740-623-6431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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