| Organization Name: | MIDSTATE MEDICAL, INC |
| NPI Number: | 1578639688 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HAROLD A MCBEE (VICE PRESIDENT) |
| Mailing Address: | 403 1st Avenue Shell Lake |
| State: | WI US |
| Postal Code: | 548710300 |
| Phone Number: | 7154682552 |
| Fax Number: | |
| NPI Enumeration Date: | 11/28/2006 |
| NPI Last Update Date: | 04/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | 009457 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |