Organization
MIDWEST MEDICAL, INC.
Active
Other names
Midwest Medical Services, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
KAY JOHNSON (BOARD MEMBER)
(605) 882-4210
Entity
Organization
Contact information
Practice address
615 6TH ST SE, WATERTOWN, SD 57201-4926
(605) 882-4210
(605) 882-4211
Mailing address
615 6TH ST SE, WATERTOWN, SD 57201-4926
(605) 882-4210
(605) 882-4211
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0077352
BLUE CROSS/ BLUE SHIELD
SD
01
—
2482
SIOUX VALLEY HEALTH PLAN
SD
01
—
2998
AVERA HEALTH PLAN
SD
05
—
447563100
—
MN
05
—
9162540
—
SD
Enumeration date
02/14/2006
Last updated
09/09/2020
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