Provider Demographics
NPI:1306280565
Name:MID-CONTINENT TECHNOLOGIES, LLC
Entity type:Organization
Organization Name:MID-CONTINENT TECHNOLOGIES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHULZ
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:402-889-7432
Mailing Address - Street 1:3000 2ND AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-3507
Mailing Address - Country:US
Mailing Address - Phone:402-403-1348
Mailing Address - Fax:877-810-8046
Practice Address - Street 1:3000 2ND AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-3507
Practice Address - Country:US
Practice Address - Phone:402-403-1348
Practice Address - Fax:877-810-8046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE01-11071729332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE01-11071729OtherSTATE OF NEBRASKA ID NUMBER