Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mimi Medical Supply LLC

Organization Clinical Medical Laboratory · NPI 1356229942

Mimi Medical Supply LLC is a Clinical Medical Laboratory in Rockford, Illinois. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1905 W Riverside Blvd
Rockford, IL 61103-1502
Phone: (872) 702-3523
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Durable Medical Equipment & Medical Supplies (primary) Taxonomy 332B00000X
Clinical Medical Laboratory Taxonomy 291U00000X

Record details

NPI number1356229942
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Heather Marlow — Manager · (667) 284-7662
NPI enumeratedAugust 22, 2025
Last updated in NPPESMarch 11, 2026
Certification dateMarch 11, 2026
Mailing address1905 W Riverside Blvd, Rockford, IL 61103-1502

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