Provider Demographics
NPI:1144543968
Name:MIDWEST MEDICAL HOLDINGS LLC
Entity type:Organization
Organization Name:MIDWEST MEDICAL HOLDINGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-780-0100
Mailing Address - Street 1:8400 CORAL SEA STREET NE
Mailing Address - Street 2:
Mailing Address - City:MOUNDS VIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55112-4398
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1119 2ND ST S
Practice Address - Street 2:SUITE 1119
Practice Address - City:WAITE PARK
Practice Address - State:MN
Practice Address - Zip Code:56387-2323
Practice Address - Country:US
Practice Address - Phone:320-258-4055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-08
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies