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Contact Information

MIDWEST MEDICAL HOLDINGS LLC
8400 CORAL SEA ST NE STE 100
SAINT PAUL, MN55112-4395
 Phone: 763-780-1500
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Infusion Therapy Pharmacy

3336H0001X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
 

Specialty Pharmacy

3336S0011X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for MIDWEST MEDICAL HOLDINGS LLC

NPI Number 1902940604
LBN Legal business name MIDWEST MEDICAL HOLDINGS LLC
Authorized official LARRY LINDBERG - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 02/16/2007
Last updated 10/17/2016 - About 10 years ago
Identifiers
MN License # 260897
MN Medicaid 569860000
Other 2047033 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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