AGNESIAN HEALTHCARE ENTERPRISES LLC NPI 1184699704

NPI Information

NPI: 1184699704
Provider Name: AGNESIAN HEALTHCARE ENTERPRISES LLC

Doing Business As: AGNESIAN HOME OXYGEN

Classification: Durable Medical Equipment & Medical Supplies - 332BX2000X
Entity Type: Organization

Specialization: Oxygen Equipment & Supplies

Address:
239 TROWBRIDGE DR
FOND DU LAC, WI
ZIP 54937
Phone: (920) 907-5364
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AGNESIAN HEALTHCARE ENTERPRISES LLC is an oxygen equipment and supplies durable medical equipment medical supplies in Fond Du Lac, WI. AGNESIAN HEALTHCARE ENTERPRISES LLC NPI is 1184699704. The provider is registered as an organization entity type.
The provider Is Doing Business As Agnesian Home Oxygen.

The provider's business location address is:

239 TROWBRIDGE DR
FOND DU LAC, WI
ZIP 54937-180
Phone: (920) 907-5364
Fax: (920) 923-7957

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

The enumeration date for this NPI number is 2/17/2006 and was last updated on 4/20/2008.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332BX2000X	Durable Medical Equipment & Medical Supplies	Oxygen Equipment & Supplies			Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	41739100	OTHER	WISCONSIN	WI CHRONIC DISEASE PROGRA
2	4368240005	MEDICARE ID-TYPE UNSPECIFIED
3	41739100	MEDICAID	WISCONSIN
4	41739100	OTHER	WISCONSIN	HIRSP
5	=========077	OTHER	WISCONSIN	BLUE CROSS OF WI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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