MEDICARE: MEDPARTNERS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134276868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDPARTNERS, INC

Provider Business Mailing Address
First Line	:	11830 W RIPLEY AVE
Second Line	:	UNIT G
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3933
Country	:	US
Telephone Number	:	414-476-2001
Fax Number	:	414-476-2001

Provider Business Practice Location Address
First Line	:	11830 W RIPLEY AVE
Second Line	:	UNIT G
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3933
Country	:	US
Telephone Number	:	414-476-2001
Fax Number	:	414-476-2001

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN BOWEN
Credential	:
Telephone Number	:	414-476-2001

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	08/22/2020

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Directions to “MEDPARTNERS, INC ” Practice Location

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