Healthcare Provider Details

I. General information

NPI: 1801866090
Provider Name (Legal Business Name): MONROE BIOTECHNOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 12/01/2022
Certification Date: 12/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 S WEBSTER AVE
GREEN BAY WI
54301-3921
US

IV. Provider business mailing address

342 S WEBSTER AVE
GREEN BAY WI
54301-3921
US

V. Phone/Fax

Practice location:
  • Phone: 920-435-3002
  • Fax: 920-884-0201
Mailing address:
  • Phone: 920-435-3002
  • Fax: 920-884-0201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateWI

VIII. Authorized Official

Name: SUMESH SAXENA
Title or Position: OWNER
Credential:
Phone: 219-791-9200