Provider Demographics
NPI:1881321966
Name:PMI ACQUISITION, LLC
Entity type:Organization
Organization Name:PMI ACQUISITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:BENCIVENGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-318-6831
Mailing Address - Street 1:12921 S VISTA STATION BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-2377
Mailing Address - Country:US
Mailing Address - Phone:813-318-6831
Mailing Address - Fax:
Practice Address - Street 1:11000 OPTUM CIR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-2503
Practice Address - Country:US
Practice Address - Phone:614-212-8413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies