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General NPI Number Information
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NPI Number | 1265387948
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Entity Type | Organization
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Legal Business Name | LA SANTE WISCONSIN INC.
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Dates
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Enumeration Date | 02/27/2026
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 1512 N GREEN MOUNT RD
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City | O FALLON
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State | IL
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Zip | 62269-2083
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Country | US
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Telephone | 920-465-3000
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Fax | 920-465-3003
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Provider Business Mailing Address
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Address Line | PO BOX 1415
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City | GREEN BAY
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State | WI
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Zip | 54305-1415
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Country | US
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Telephone | 920-465-3000
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Fax | 920-465-3003
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAROD HUSMANN
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Credential |
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Telephone | 920-884-5327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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