MEDICARE: MEDICAL EQUIPMENT SPECIALISTS 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	225100000X	Physical Therapist
2	2278C0205X	Critical Care Certified Respiratory Therapist		WI
3	2278E0002X	Emergency Care Certified Respiratory Therapist		WI
4	2278G0305X	Geriatric Care Certified Respiratory Therapist		WI
5	2278P1004X	Pulmonary Diagnostics Certified Respiratory Therapist		WI
6	2278P1005X	Pulmonary Rehabilitation Certified Respiratory Therapist	1409-028	WI
7	2278P3900X	Neonatal/Pediatric Certified Respiratory Therapist		WI
8	227900000X	Registered Respiratory Therapist	1409-028	WI
9	2279E1000X	Educational Registered Respiratory Therapist	1409-028	WI
10	2279G1100X	General Care Registered Respiratory Therapist		WI
11	2279P1006X	Pulmonary Function Technologist Registered Respiratory Therapist	1409-028	WI
12	2279H0200X	Home Health Registered Respiratory Therapist	1409-028	WI

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	:	1326252198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL EQUIPMENT SPECIALISTS INC

Provider Business Mailing Address
First Line	:	11220 W LAPHAM ST
Second Line	:
City	:	WEST ALLIS
State	:	WI
Zip	:	53214-3806
Country	:	US
Telephone Number	:	414-282-5451
Fax Number	:	414-282-5467

Provider Business Practice Location Address
First Line	:	11220 W LAPHAM ST
Second Line	:
City	:	WEST ALLIS
State	:	WI
Zip	:	53214-3806
Country	:	US
Telephone Number	:	414-282-5451
Fax Number	:	414-282-5467

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	MR. CHARLES MARK SISSON
Credential	:	RCP
Telephone Number	:	414-282-5451

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	09/11/2025

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