MEDICARE: MID-US MEDICAL INC.

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

General Provider Information

NPI Number	:	1962553438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MID-US MEDICAL INC.

Provider Business Mailing Address
First Line	:	5330 HEATHERDOWNS BLVD STE 102
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-4644
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5330 HEATHERDOWNS BLVD STE 102
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-4644
Country	:	US
Telephone Number	:	419-787-7506
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. EKI IMAGBE
Credential	:
Telephone Number	:	419-787-7506

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	08/22/2020

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