Provider Demographics
NPI:1629448022
Name:MIDWEST BIOLOGICS, INC.
Entity Type:Organization
Organization Name:MIDWEST BIOLOGICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, TREASURER, SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:CAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-494-3121
Mailing Address - Street 1:6323 W 110TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1509
Mailing Address - Country:US
Mailing Address - Phone:913-851-0755
Mailing Address - Fax:
Practice Address - Street 1:6323 W 110TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1509
Practice Address - Country:US
Practice Address - Phone:913-851-0755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUPERIOR BIOLOGICS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-09-29
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2131973336C0003X, 3336H0001X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy