Organization Name: | MILE BLUFF CLINIC, LLP |
NPI Number: | 1255512547 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CAROL FRONK (ADMINISTRATOR) |
Mailing Address: | 1515 Academy St Elroy |
State: | WI US |
Postal Code: | 539291011 |
Phone Number: | 6084628466 |
Fax Number: | |
NPI Enumeration Date: | 11/15/2007 |
NPI Last Update Date: | 06/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy 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 |