Healthcare Provider Details
I. General information
NPI: 1407779135
Provider Name (Legal Business Name): MEDICORE EQUIPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
W1972 60TH ST
LYNDON STATION WI
53944-9531
US
IV. Provider business mailing address
W1972 60TH ST
LYNDON STATION WI
53944-9531
US
V. Phone/Fax
- Phone: 619-416-6927
- Fax:
- Phone: 619-416-6927
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BENJAMIN
L
HANKLE
Title or Position: CEO
Credential:
Phone: 619-416-6927