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MIMI MEDICAL SUPPLY LLC
NPI 1356229942
Durable Medical Equipment & Medical Supplies in Rockford, IL

Active since August 22, 2025CLIA 14D2333714 · Waiver
1905 W RIVERSIDE BLVD, ROCKFORD, IL 61103(872) 702-3523 Get Directions Write a Review

NPPES record last updated: March 11, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Mar 11, 2026, Nov 3, 2025 (2 updates tracked since 2025).

About Mimi Medical Supply Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIMI MEDICAL SUPPLY LLC (NPI 1356229942) is a healthcare organization registered as a durable medical equipment & medical supplies in Rockford, Illinois and active in the NPI registry since August 2025. The organization holds a CLIA Waiver certificate valid through November 9, 2027 and lists Heather Marlow, Manager, as its authorized official.

NPPES Registry Identity

NPI1356229942
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameMIMI MEDICAL SUPPLY LLC
Location Address1905 W RIVERSIDE BLVDRockford, IL 61103-1502
Mailing Address1905 W Riverside BlvdRockford, IL 61103-1502 · (872) 702-3523
Phone(872) 702-3523
Organization SubpartNo
Authorized OfficialHeather MarlowManager · (667) 284-7662
Enumeration DateAugust 22, 2025
Last NPPES UpdateMarch 11, 20262 updates tracked since enumeration
NPPES CertifiedMarch 11, 2026
✔ NPI 1356229942 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
Also ListedClinical Medical LaboratoryTaxonomy 291U00000X
1905 W RIVERSIDE BLVD, Rockford, IL 61103
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2333714

Mimi Medical Supply LLC · Rockford, IL
Active · expires Nov 9, 2027
CLIA Number14D2333714
Laboratory TypeIndependent
Certificate Effective DateNovember 10, 2025
Certificate Expiration DateNovember 9, 2027
Laboratory DirectorHeather Marlow
Laboratory Phone(872) 702-3523
Laboratory LocationMimi Medical Supply LLC1905 W Riverside Blvd, Rockford, IL 61103
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mimi Medical Supply LLC's NPI number?

The NPI number for Mimi Medical Supply LLC is 1356229942. It was assigned to this organization in the NPPES registry on August 22, 2025.

Where is Mimi Medical Supply LLC located?

Mimi Medical Supply LLC is located at 1905 W Riverside Blvd, Rockford, IL 61103. The listed phone number is (872) 702-3523.

What is Mimi Medical Supply LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Mimi Medical Supply LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2333714) is associated with this NPI, valid through November 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mimi Medical Supply LLC was last updated on March 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.