Organization Name:  MIV INC


Practice Location:
706 MAIN ST  FREELAND, PA 18224 US
Tel: 570-636-0480  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	3336L0003X	Suppliers Pharmacy Long Term Care Pharmacy	PA	PP481528
N	333600000X	Suppliers Pharmacy	PA	PP481528
Y	3336C0003X	Suppliers Pharmacy	PA	PP481528

Other Provider Identifiers:

Issuer	Number	State	Type
OTHER ID NUMBER-COMMERCIAL NUMBER	3987382		01

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin