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General NPI Number Information
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NPI Number | 1538933270
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Entity Type | Organization
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Legal Business Name | PURE MEDICAL INC
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 10437 W INNOVATION DR STE B7
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City | MILWAUKEE
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State | WI
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Zip | 53226-4879
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Country | US
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Telephone | 414-928-4855
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Fax | 414-928-5315
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Provider Business Mailing Address
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Address Line | 10437 W INNOVATION DR STE B7
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City | MILWAUKEE
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State | WI
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Zip | 53226-4879
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Country | US
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Telephone | 414-928-4855
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Fax | 414-928-5315
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Authorized Official
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Title or Position | CO-FOUNDER, REGISTERED AGENT
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Name | MR. THOMAS MARTIN STOCCO
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Credential |
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Telephone | 414-732-6515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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