Provider Demographics
NPI:1396853495
Name:MIDWEST MEDICAL TESTING LLC
Entity Type:Organization
Organization Name:MIDWEST MEDICAL TESTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:HILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-827-8670
Mailing Address - Street 1:PO BOX 779
Mailing Address - Street 2:
Mailing Address - City:CONNERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47331-0779
Mailing Address - Country:US
Mailing Address - Phone:765-827-8670
Mailing Address - Fax:765-827-1903
Practice Address - Street 1:1475 E STATE ROAD 44
Practice Address - Street 2:
Practice Address - City:CONNERSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47331-8292
Practice Address - Country:US
Practice Address - Phone:765-827-8670
Practice Address - Fax:765-827-1903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology