Provider Demographics
NPI:1730588674
Name:MIDWEST HEALTH SOLUTIONS LLC
Entity type:Organization
Organization Name:MIDWEST HEALTH SOLUTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:TINDALL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:573-438-3733
Mailing Address - Street 1:612 E HIGH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:POTOSI
Mailing Address - State:MO
Mailing Address - Zip Code:63664-1425
Mailing Address - Country:US
Mailing Address - Phone:573-438-7333
Mailing Address - Fax:573-438-0046
Practice Address - Street 1:612 E HIGH ST
Practice Address - Street 2:
Practice Address - City:POTOSI
Practice Address - State:MO
Practice Address - Zip Code:63664-1429
Practice Address - Country:US
Practice Address - Phone:573-438-3733
Practice Address - Fax:573-438-0046
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDWEST HEALTH SOLUTIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-16
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1528306652OtherPEDIATRIC NP