Organization
MIRATECH LABORATORY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMIE NICHOLS (CEO)
(317) 509-2016
Entity
Organization
Contact information
Practice address
11404 HANBURY MANOR BLVD, NOBLESVILLE, IN 46060-7179
(800) 840-1673
(317) 830-6393
Mailing address
11404 HANBURY MANOR BLVD, NOBLESVILLE, IN 46060-7179
(800) 840-1673
(317) 830-6393
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/14/2023
Last updated
03/14/2023
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