Provider Demographics
NPI:1134746084
Name:MIDWEST MONITORING LLC
Entity type:Organization
Organization Name:MIDWEST MONITORING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:VINSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM
Authorized Official - Phone:479-713-0078
Mailing Address - Street 1:PO BOX 1205
Mailing Address - Street 2:DEPT # 3343
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72033
Mailing Address - Country:US
Mailing Address - Phone:833-526-7075
Mailing Address - Fax:
Practice Address - Street 1:4504 FURLONG DR
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-6681
Practice Address - Country:US
Practice Address - Phone:833-526-7075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty