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General NPI Number Information
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NPI Number | 1356592794
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Entity Type | Organization
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Legal Business Name | MEDINET LLC
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Dates
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Enumeration Date | 10/03/2008
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Last Update Date | 10/03/2008
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Provider Practice Location Address
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Address Line | N114W19049 CLINTON DR
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City | GERMANTOWN
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State | WI
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Zip | 53022-3011
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Country | US
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Telephone | 262-255-9653
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Fax |
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Provider Business Mailing Address
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Address Line | N114W19049 CLINTON DR
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City | GERMANTOWN
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State | WI
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Zip | 53022-3011
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PETER ERICKSON
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Credential |
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Telephone | 262-255-9653
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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 | 004000183384101
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License Number State | WI
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