Provider Demographics
NPI:1780799296
Name:MIDTOWN INVESTMENTS LLC
Entity type:Organization
Organization Name:MIDTOWN INVESTMENTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:R
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-842-7380
Mailing Address - Street 1:7100 NORTHLAND CIR N
Mailing Address - Street 2:SUITE 410
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55428-1548
Mailing Address - Country:US
Mailing Address - Phone:763-535-0118
Mailing Address - Fax:763-536-0932
Practice Address - Street 1:15411 VANTAGE PKWY W
Practice Address - Street 2:SUITE 212
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77032-1903
Practice Address - Country:US
Practice Address - Phone:281-227-2212
Practice Address - Fax:281-227-2215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0089709332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5622220016Medicare NSC