Healthcare Provider Details

I. General information

NPI: 1992846836
Provider Name (Legal Business Name): SPECIALIZED MEDICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 12/30/2020
Certification Date: 12/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2875 S 171ST ST
NEW BERLIN WI
53151-3511
US

IV. Provider business mailing address

5343 N 118TH CT
MILWAUKEE WI
53225-3085
US

V. Phone/Fax

Practice location:
  • Phone: 414-476-1112
  • Fax: 414-476-6118
Mailing address:
  • Phone: 414-476-1112
  • Fax: 414-476-6118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: GREGORY MCCARTHY
Title or Position: CHIEF OPERATIONS OFFICER
Credential: AO
Phone: 727-530-7700