Healthcare Provider Details

I. General information

NPI: 1689698151
Provider Name (Legal Business Name): WHEATON FRANCISCAN MEDICAL EQUIPMENT TEAM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 01/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3070 N 51ST ST STE 406
MILWAUKEE WI
53210-1661
US

IV. Provider business mailing address

3070 N 51ST ST STE 406
MILWAUKEE WI
53210-1661
US

V. Phone/Fax

Practice location:
  • Phone: 414-874-6171
  • Fax: 414-874-6119
Mailing address:
  • Phone: 414-874-6171
  • Fax: 414-874-6119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1695-045
License Number StateWI

VIII. Authorized Official

Name: MR. JAMES GRESHAM
Title or Position: PRESIDENT
Credential:
Phone: 414-874-6276