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General NPI Number Information
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NPI Number | 1487780789
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Entity Type | Organization
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Legal Business Name | ACTIVE SALES & SERVICES MEDICAL EQUIPMENT CENTER
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 06/01/2009
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Provider Practice Location Address
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Address Line | 3817 N OAKLAND AVE
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City | MILWAUKEE
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State | WI
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Zip | 53211-2240
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Country | US
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Telephone | 414-906-1560
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Fax | 414-906-1566
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Provider Business Mailing Address
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Address Line | 3817 N OAKLAND AVE
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City | MILWAUKEE
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State | WI
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Zip | 53211-2240
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Country | US
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Telephone | 414-906-1560
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | LEONID SHEYNBUK
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Credential |
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Telephone | 414-906-1560
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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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