Healthcare Provider Details

I. General information

NPI: 1740722172
Provider Name (Legal Business Name): MONROE MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2016
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 16TH AVE
MONROE WI
53566-1764
US

IV. Provider business mailing address

1015 16TH AVE
MONROE WI
53566-1764
US

V. Phone/Fax

Practice location:
  • Phone: 608-329-6300
  • Fax: 608-328-4489
Mailing address:
  • Phone: 608-329-6300
  • Fax: 608-328-4468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number456-1029319482-02
License Number StateWI

VIII. Authorized Official

Name: MORGAN VOEGELI
Title or Position: MANAGING MEMBER
Credential:
Phone: 608-329-6300