Provider Demographics
NPI:1396185732
Name:MISA TECHNOLOGIES, LLC
Entity Type:Organization
Organization Name:MISA TECHNOLOGIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMMIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-875-9528
Mailing Address - Street 1:617 N MERIDIAN RD STE C
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-5126
Mailing Address - Country:US
Mailing Address - Phone:620-875-9528
Mailing Address - Fax:
Practice Address - Street 1:116 SPRINGLAKE DR
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-5572
Practice Address - Country:US
Practice Address - Phone:620-875-9528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-30
Last Update Date:2013-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies