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General NPI Number Information
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NPI Number | 1568580207
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Entity Type | Organization
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Legal Business Name | PERSONAL COMFORT SUPPLIES OF WI
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1220 MOUND AVE SUITE 315
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City | RACINE
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State | WI
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Zip | 53404-3350
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Country | US
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Telephone | 188-836-4360
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Fax |
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Provider Business Mailing Address
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Address Line | 18501 ALEXIS CT
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City | HAZEL CREST
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State | IL
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Zip | 60429-2467
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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 | NICOLE MCTIZIC
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Credential |
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Telephone | 18883643600
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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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