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General NPI Number Information
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NPI Number | 1083797252
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Entity Type | Organization
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Legal Business Name | MIDWEST MEDICAL EQUIPMENT & SUPPLIES, INC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 530 E 2ND ST
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City | DULUTH
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State | MN
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Zip | 55805-1913
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Country | US
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Telephone | 218-786-4368
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Fax | 218-722-9988
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Provider Business Mailing Address
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Address Line | 530 E 2ND ST
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City | DULUTH
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State | MN
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Zip | 55805-1913
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Country | US
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Telephone | 218-786-4368
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Fax | 218-722-9988
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Authorized Official
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Title or Position | CFO
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Name | KEVIN BOREN
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Credential |
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Telephone | 218-786-1009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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