Organization
MIDWEST MEDICAL HOLDINGS LLC
Active
Organization
MIDWEST MEDICAL HOLDINGS LLC
Active
Other names
MIDWEST IV AND HOMECARE
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY LINDBERG RPH (CEO)
(763) 780-1500
Entity
Organization
Contact information
Practice address
8400 CORAL SEA ST NE STE 100, SAINT PAUL, MN 55112-4395
(763) 780-1500
Mailing address
PO BOX 18310, MINNEAPOLIS, MN 55418-0310
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
260897
MN
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2047033
PK
—
05
—
569860000
—
MN
Enumeration date
02/16/2007
Last updated
10/17/2016
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