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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