DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: DR WAGNER SOUTHRIDGE OPTICAL LLC

MEDICARE: DR WAGNER SOUTHRIDGE OPTICAL LLC
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
1332H00000XEyewear Supplier

General Provider Information

NPI Number : 1255591236
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR WAGNER SOUTHRIDGE OPTICAL LLC
Provider Business Mailing Address
First Line : 5300 S 76TH ST
Second Line : STE 690
City : GREENDALE
State : WI
Zip : 53129-1102
Country : US
Telephone Number : 414-855-0469
Fax Number : 414-855-0492
Provider Business Practice Location Address
First Line : 5300 S 76TH ST
Second Line : STE 690
City : GREENDALE
State : WI
Zip : 53129-1102
Country : US
Telephone Number : 414-855-0469
Fax Number : 414-855-0492
Authorized Official
Title or Position : MANAGER
Name : MRS. JOAN E SERRANO
Credential :
Telephone Number : 414-855-0469
Provider Enumeration Date : 06/12/2008
Last Update Date : 08/17/2009

Similar Medicare Providers

1912896275 — PLAYLAB COLLECTIVE, INC
Practice Location Address:
5300 S 76TH ST
GREENDALE, WI
53129-1102
Practice Phone: 262-497-7270
Practice Fax: 877-540-0135
1548341597 — STEIN OPTICAL INC
Practice Location Address:
5300 S 76TH ST
GREENDALE, WI
53129-1102
Practice Phone: 414-421-6450
Practice Fax: 414-421-0261
1447316468 — MICHAEL LINDEMEYER OD
Practice Location Address:
5300 S 76TH ST
GREENDALE, WI
53129-1102
Practice Phone: 414-421-6450
Practice Fax: 414-421-0261
1336285998 — PEARLE VISION INC
Practice Location Address:
5300 S 76TH ST
GREENDALE, WI
53129-1102
Practice Phone: 414-421-9330
Practice Fax: 414-421-3159
1205977733 — DR. JOHN MONTY OD
Practice Location Address:
5300 S 76TH ST
GREENDALE, WI
53129-1102
Practice Phone: 414-421-9330
Practice Fax: 414-421-3159
1902026206 — DR. JAMES P WAGNER OD
Practice Location Address:
5300 S 76TH ST , STE 690
GREENDALE, WI
53129-1102
Practice Phone: 414-855-0469
Practice Fax: 414-855-0492

Directions to “DR WAGNER SOUTHRIDGE OPTICAL LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.