Provider Demographics
NPI:1780330357
Name:MIR-MEDICAL INTERNATIONAL RESEARCH USA, INC
Entity type:Organization
Organization Name:MIR-MEDICAL INTERNATIONAL RESEARCH USA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATIONAL DIRECTOR OF SALES
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-202-4388
Mailing Address - Street 1:5462 S WESTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-7948
Mailing Address - Country:US
Mailing Address - Phone:844-464-7872
Mailing Address - Fax:
Practice Address - Street 1:5462 S WESTRIDGE DR
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-7948
Practice Address - Country:US
Practice Address - Phone:844-464-7872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies