AGNESIAN HEALTHCARE NPI 1114963261

NPI Information

AGNESIAN HEALTHCARE is a durable medical equipment medical supplies in Mount Calvary, WI. The provider is 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. AGNESIAN HEALTHCARE NPI is 1114963261. The provider is registered as an organization entity type.
The provider Is Doing Business As Fond Du Lac Regional Clinic.

The provider's business location address is:

100 EVERGREEN RD
MOUNT CALVARY, WI
ZIP 53057-726
Phone: (920) 753-2311

The provider's authorized official is Steven Little .
The authorized official title is Svp & Cfo and has the following contact phone number (920) 926-5402.

The CLIA number assigned to this NPI record is 52D2111114 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/20/2006 and was last updated on 3/15/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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