Provider Demographics
NPI:1093709677
Name:MIDWEST MEDICAL INC.
Entity Type:Organization
Organization Name:MIDWEST MEDICAL INC.
Other - Org Name:MIDWEST MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-422-9999
Mailing Address - Street 1:422 S PIERCE AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-2739
Mailing Address - Country:US
Mailing Address - Phone:641-422-9999
Mailing Address - Fax:641-422-9999
Practice Address - Street 1:422 S PIERCE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2739
Practice Address - Country:US
Practice Address - Phone:641-422-9999
Practice Address - Fax:641-422-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0254920Medicaid
IA0254920Medicaid