Provider Demographics
NPI:1487801692
Name:MIDWEST MEDICAL ASSOCIATES, INC.
Entity type:Organization
Organization Name:MIDWEST MEDICAL ASSOCIATES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-696-0663
Mailing Address - Street 1:2295 PARKLAKE DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-2816
Mailing Address - Country:US
Mailing Address - Phone:843-696-0663
Mailing Address - Fax:678-578-6252
Practice Address - Street 1:2295 PARKLAKE DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-2816
Practice Address - Country:US
Practice Address - Phone:877-593-3546
Practice Address - Fax:877-593-9689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies