Provider Demographics
NPI:1508160250
Name:HEALTHCARE MIDWEST, PC
Entity Type:Organization
Organization Name:HEALTHCARE MIDWEST, PC
Other - Org Name:K-VALLEY ORTHOPEDICS-A DIVISION OF HEALTHCARE MIDWEST, PC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:TEN CATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-343-8170
Mailing Address - Street 1:4341 SOUTH WESTNEDGE AVENUE
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008
Mailing Address - Country:US
Mailing Address - Phone:269-488-2176
Mailing Address - Fax:269-343-9769
Practice Address - Street 1:13326 N BOULEVARD ST
Practice Address - Street 2:
Practice Address - City:VICKSBURG
Practice Address - State:MI
Practice Address - Zip Code:49097-1514
Practice Address - Country:US
Practice Address - Phone:269-649-2321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHCARE MIDWEST, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies