Provider Demographics
NPI:1043752348
Name:MIDWEST MEDICAL DEVICE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:MIDWEST MEDICAL DEVICE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-220-3090
Mailing Address - Street 1:1852 WINEGARD DR
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021-5837
Mailing Address - Country:US
Mailing Address - Phone:636-220-3090
Mailing Address - Fax:
Practice Address - Street 1:134 ENCHANTED PKWY
Practice Address - Street 2:SUITE 203
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63021-5495
Practice Address - Country:US
Practice Address - Phone:636-220-3090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care