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AGNESIAN HEALTHCARE INC NPI 1962748319


NPI Information

NPI: 1962748319
Provider Name: AGNESIAN HEALTHCARE INC

Doing Business As: FOND DU LAC REGIONAL CLINIC

Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization

CLIA Number: 52D2197672

Address:
451 E BROOKLYN ST
CHILTON, WI
ZIP 53014
Phone: (920) 849-4682
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AGNESIAN HEALTHCARE INC is a durable medical equipment medical supplies in Chilton, 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 INC NPI is 1962748319. 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:

451 E BROOKLYN ST
CHILTON, WI
ZIP 53014-595
Phone: (920) 849-4682

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

The CLIA number assigned to this NPI record is 52D2197672 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/12/2012 and was last updated on 12/12/2012.


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
1332B00000XDurable Medical Equipment & Medical SuppliesYes

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

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