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Contact Information

MIIVRX LLC
49 E ISABELLA RD
MIDLAND, MI48640-8356
 Phone: 989-631-3636
 Fax: 989-832-6091
 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
 

Customized Equipment

332BC3200X 87 All Other Suppliers
 

Department of Veterans Affairs (VA) Pharmacy

332100000X 87 All Other Suppliers
 

Parenteral & Enteral Nutrition

332BP3500X 87 All Other Suppliers
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Specialty Pharmacy

3336S0011X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for MIIVRX LLC

NPI Number 1932272523
LBN Legal business name MIIVRX LLC
Authorized official KEVIN ROEDER - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 11/15/2006
Last updated 09/19/2025 - About 9 months ago
Identifiers
MI License # 5301010544
MI Medicaid 1710362
Other 2145782 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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