Organization
MIIVRX LLC
Active
Other names
MiIVRx
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN ROEDER RPH (CEO)
(989) 631-3636
Entity
Organization
Contact information
Practice address
49 E ISABELLA RD, MIDLAND, MI 48640-8356
(989) 631-3636
(989) 832-6091
Mailing address
49 E ISABELLA RD, SUITE A, MIDLAND, MI 48640-8356
(989) 631-3636
(989) 832-6091
Taxonomy
Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
5301010544
MI
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710362
—
MI
01
—
2145782
PK
—
Enumeration date
11/15/2006
Last updated
09/19/2025
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